Part Part 3 - Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2023 - Impairment Tables | Zoe
Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2023
Part 3Impairment Tables
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Table 1 – Functions requiring Physical Exertion and Stamina
| Introduction to Table 1 |
| Table 1 is to be used to assess the functional impact of a diagnosed condition when performing activities requiring physical exertion or stamina.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist confirming diagnosis of conditions commonly associated with cardiac or respiratory impairment (such as cardiac failure, cardiomyopathy, ischaemic heart disease, chronic obstructive airways/pulmonary disease, asbestosis, mesothelioma, or lung cancer);a report from a medical specialist confirming the diagnosis of conditions commonly associated with fatigue or exhaustion (such as diabetes mellitus, renal failure, end stage organ failure, widespread/metastatic cancer, chronic pain, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), lymphoedema and fibromyalgia), and providing details of treatment, functional impact and prognosis;results of exercise, cardiac stress, treadmill testing or actimetry linked blood pressure and heart rate monitoring.<br>When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions (such as migraines, chronic pain or transient ischaemic attacks), a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide.Assistance means assistance from another person rather than any aids or equipment the person may use, unless specified otherwise. |
| 0 | There is no or minimal functional impact on activities requiring physical exertion or stamina.<br> <br>(1) The person:<br> <br>(a) is able to undertake exercise appropriate to their age for at least 30 minutes at a time; and<br>(b) has no or minimal difficulty completing physically active tasks around their home and community; and<br>(c) can undertake personal care activities such as showering or bathing and these activities do not prevent the person from undertaking a full range of activities in the same day. |
| 5 | There is a mild functional impact on activities requiring physical exertion or stamina.<br>(1) The person:<br>(a) experiences occasional symptoms such as mild shortness of breath, fatigue, pain, or mild post-exertional malaise, when performing physically demanding activities and, due to these symptoms, the person has mild difficulty:<br>(i) walking or mobilising in a wheelchair or other equivalent assistive technology to local facilities without stopping to rest; or<br>Example: going to local shops or supermarket, larger workplace, education or training campus.<br>(ii) performing physically active tasks or heavier household activities; and<br> Example 1: climbing a flight of stairs or mobilising up a long, sloping pathway or ramp if in a wheelchair.<br> Example 2: vacuuming floors or mowing the lawn.<br>(b) is able to perform most work-related tasks, other than tasks involving heavy manual labour.<br> Example: digging, carrying or moving heavy objects, concreting, bricklaying, or laying pavers. |
| 10 | There is a moderate functional impact on activities requiring physical exertion or stamina.<br>(1) The person:<br>(a) experiences frequent symptoms such as moderate shortness of breath, fatigue, pain, or post-exertional malaise, when performing day-to-day activities around the home and community and, due to these symptoms, the person has moderate difficulty:<br>(i) walking or mobilising in a wheelchair or other equivalent assistive technology far outside the home and needs to drive or get other transport to local facilities; or<br>Example: going to local shops or supermarket, workplace, education or training campus.<br>(ii) performing day-to-day household activities; or<br>Example: changing sheets, washing and putting away dishes or sweeping paths.<br>(iii) performing personal care activities such as showering or bathing and needs to plan and schedule showering or bathing around other activities to ensure they are not doing too much in any one day; and<br>(b) is able to:<br>(i) use public transport and walk or mobilise in a wheelchair around local facilities such as local shops, workplaces, or a supermarket; and<br>(ii) perform work-related tasks of a clerical, sedentary or stationary nature (i.e. tasks not requiring a high level of physical exertion). |
| 20 | There is a severe functional impact on activities requiring physical exertion or stamina.<br>(1) The person:<br>(a) usually experiences symptoms such as severe shortness of breath, fatigue, post-exertional malaise, or pain when performing light physical activities and, due to these symptoms, the person has severe difficulty:<br>(i) walking or mobilising in a wheelchair or other equivalent assistive technology from the carpark, into and around local facilities without assistance; or<br>Example: going to local shops or supermarket, workplace, education or training campus.<br>(ii) using public transport without assistance; or<br>(iii) performing light day-to-day household activities without requiring a long recovery period afterwards; or<br> Example: preparing a simple meal, dusting, folding and putting away laundry or light gardening.<br>(iv) performing personal care activities without assistance; and<br>Example: the activity will cause severe fatigue and the person needs to rest before and after showering/bathing, and can undertake minimal to no other activities for the rest of that day.<br>(b) has or is likely to have severe difficulty sustaining work-related tasks of a clerical, sedentary or stationary nature for a shift of at least 3 hours. |
| 30 | There is an extreme functional impact on activities requiring physical exertion or stamina.<br>(1) The person:<br>(a) is unable to perform activities requiring physical exertion or stamina; or<br>(b) experiences symptoms such as extreme shortness of breath, extreme fatigue or pain when performing any activities requiring physical exertion or stamina and, due to these symptoms, the person is unable to move around inside the home without assistance; or<br>(c) is unable to undertake personal care activities and needs assistance to use the bathroom or is reliant on bed baths or using wet wipes. Such activities result in severe fatigue; or<br>(d) is bedbound.<br>Note: this impairment rating level includes people who require Oxygen treatment.<br> Example: requiring the use of an Oxygen concentrator during the day or to move around. |
Table 2 – Upper Limb Function
| Introduction to Table 2 |
| Table 2 is to be used to assess the functional impact of a diagnosed condition when performing activities requiring the use of upper limbs.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist confirming diagnosis of conditions associated with upper limb impairment (such as arthritis or other condition affecting upper limb joints, paralysis or loss of strength or sensation resulting from stroke or other brain or nerve injury, cerebral palsy or other condition affecting upper limb coordination, inflammation or injury of the muscles or tendons of the upper limbs, chronic pain affecting the upper limbs, amputation or absence of whole or part of upper limb, lymphoedema, or peripheral neuropathy);a report from an allied health practitioner (such as physiotherapist, occupational therapist or exercise physiologist) confirming the functional impact;results of diagnostic tests (such as X-Rays or other imagery);results of physical tests or assessments.<br>For the purposes of this Table, upper limbs extend from the shoulder to the fingers.If a person’s dominant upper limb is impaired, consideration should be given to their ability to adapt and use their non-dominant upper limb to perform tasks.When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions (such as chronic pain), a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide.Assistance means assistance from another person rather than any aids or equipment the person may use, unless specified otherwise. |
| 0 | There is no or minimal functional impact on activities using upper limbs.<br>(1) The person can pick up, handle, manipulate and use most objects encountered on a daily basis without difficulty. |
| 5 | There is a mild functional impact on activities using upper limbs.<br>(1) The person can manage most daily activities requiring the use of the upper limbs, but has mild difficulty with at least 3 of the following:<br>(a) picking up heavier objects;<br> Example: picking up and using large bulky tools such as a leaf blower, or picking up and pouring a full kettle.<br>(b) handling very small objects;<br> Example: picking up coins or picking up and using paper clips or pins.<br>(c) doing up buttons or tying laces;<br>(d) reaching up above head height or out to pick up objects.<br>Example: reaching overhead to retrieve a kitchen appliance, stocking deep or high shelves, hanging heavy washing overhead or changing a ceiling light bulb. |
| 10 | There is a moderate functional impact on activities using upper limbs.<br>(1) The person has moderate difficulty carrying out at least 4 of the following:<br>(a) picking up a 1 litre carton full of liquid;<br>(b) picking up a light but bulky object requiring the use of 2 hands together;<br> Example: a cardboard box.<br>(c) holding and using a pen or pencil;<br>(d) doing up buttons, tying shoelaces or doing up a zipper;<br>Example: wearing clothing that goes on over the head to avoid doing up buttons.<br>(e) raising arms to dress or wash hair, or reaching into a cupboard at head height; <br>(f) using a standard computer keyboard, mouse or phone functions;<br>(g) carrying out a function such as grip and twist or pinch and pull.<br>Example 1: unscrewing the lid on a bottle or jar, or turning a tap.<br> Example 2: opening food packaging |
| 20 | There is a severe functional impact on activities using upper limbs.<br>(1) At least 3 of the following apply to the person:<br>(a) the person has limited movement or coordination in both upper limbs, has an amputation or nerve damage rendering an upper limb non-functional;<br>(b) the person has severe difficulty handling, moving or carrying most objects without assistance;<br>(c) the person has severe difficulty using a small object;<br> Example: holding and using a fork or spoon, holding and using a pen or pencil.<br>(d) the person has severe difficulty turning the pages of a book without assistance;<br>(e) the person has severe difficulty undertaking any activity that involves reaching overhead.<br>Example: accessing items above shoulder height, brushing hair. |
| 30 | There is an extreme functional impact on activities using upper limbs.<br>(1) The person has no function in both of their upper limbs or the person has no upper limbs.<br> |
Table 3 – Lower Limb Function
| Introduction to Table 3 |
| Table 3 is to be used to assess the functional impact of a diagnosed condition when performing activities requiring the use of lower limbs.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist confirming diagnosis of conditions associated with lower limb impairment (such as arthritis or other condition affecting lower limb joints, paralysis or loss of strength or sensation resulting from stroke or other brain or nerve injury, cerebral palsy or other condition affecting lower limb coordination, inflammation or injury of the muscles or tendons of the lower limbs, chronic pain affecting the lower limbs, amputation or absence of whole or part of lower limb, lymphoedema, or peripheral neuropathy);a report from an allied health practitioner (such as physiotherapist, occupational therapist or exercise physiologist) confirming the functional impairment;results of diagnostic tests (such as X-Rays or other imagery);results of physical tests or assessments showing impaired function of the lower limbs.<br>For the purposes of this Table lower limbs extend from the hips to the toes.The functional impact on lower limbs resulting from lumbar spine conditions, such as nerve pain or weakness in the lower limbs, is to be assessed under Table 3.When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions (such as chronic pain), a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide.Assistance means assistance from another person rather than any aids or equipment the person may use, unless specified otherwise. |
| 0 | There is no or minimal functional impact on activities requiring use of the lower limbs.<br>(1) The person has no or minimal difficulty performing activities involving standing, squatting or kneeling and rising to a standing position, negotiating stairs and walking around their home and in the community. |
| 5 | There is a mild functional impact on activities using lower limbs.<br>(1) At least one of the following applies:<br>(a) the person has mild difficulty walking on slopes or uneven ground; or<br>Example: walking to local facilities such as local shops, workplaces, a supermarket, or bus-stop where there is uneven terrain.<br>(b) the person has mild difficulty walking on level ground without stopping; or<br>Example: walking around local facilities such as local shops or a supermarket without stopping.<br>(c) the person has mild difficulty negotiating stairs; and<br>Example: is likely to require the use of a structural support, such as a hand rail to negotiate a flight of stairs.<br>(2) At least one of the following applies:<br>(a) the person has mild difficulty standing independently; or<br>Example: waiting in a slow moving queue or standing still.<br>(b) the person has mild difficulty squatting or kneeling, but does not require support to stand up again; or<br>Example: kneeling to tie a shoe and does not require support to stand again.<br> <br>(c) the person can mobilise effectively but needs to use a walking aid to assist with walking or balance issues.<br> Example: tripping due to neurological conditions such as Multiple Sclerosis, Parkinson’s Disease or cerebellar function. |
| 10 | There is a moderate functional impact on activities using lower limbs.<br>(1) At least one of the following applies:<br>(a) the person has moderate difficulty walking on slopes or uneven ground; or<br>Example: the person has moderate difficulty walking far outside their home on uneven ground and needs to drive or get other transport to local facilities such as a local shop, workplace or supermarket.<br>(b) the person has moderate difficulty using stairs or steps without assistance or without using alternate methods; or<br>Example: the person may navigate stairs one at a time, sideways or require breaks, or navigates stairs with reliance on other structural support such as a hand rail to maintain balance.<br>(c) the person has moderate difficulty standing for short periods of time; or<br>Example: the person has moderate difficulty standing in a queue at a supermarket check out.<br>(d) the person has moderate difficulty kneeling or squatting and requires support of a stable object to stand again; and<br>Example: the person supports themselves using a coffee table to stand from a kneeling or squatting position.<br>(2) The person is able to use public transport or a motor vehicle and walk on level ground.<br>Example: is able to catch a bus and walk around in a workplace, shopping centre or supermarket.<br>Note 1: this impairment rating level includes a person who can:<br>(a) move around independently using a wheelchair and can independently transfer to and from a wheelchair; or<br> Example: the person can use a wheelchair accessible toilet independently.<br>(b) move around independently using walking aids such as a quad stick, crutches or walking frame.<br>Note 2: the person may require additional time and effort to move around a workplace, may need to use accessible entries, lifts and toilets, and may not be able to access some areas of a workplace or training facility. |
| 20 | There is a severe functional impact on activities using lower limbs.<br>(1) The person:<br>(a) has severe difficulty undertaking any of the following without assistance:<br>(i) standing up from a sitting position in a standard chair;<br>Example: the person has severe difficulty standing after being seated in a dining chair.<br> (ii) remaining standing independently;<br>(iii) walking around their home and in the community; and<br>Example: the person has severe difficulty walking from the carpark into local facilities and walking around local facilities such as shop or supermarket without assistance.<br> (b) requires assistance to use public transport.<br> Note: this impairment rating level includes a person who requires assistance to:<br>(a) move around in, or transfer to and from a wheelchair; or<br>Example: the person needs personal care assistance to use a toilet.<br>(b) move around using walking aids such as a quad stick, crutches or walking frame such as the person requires assistance from another person to walk on some surfaces and could not move independently around a workplace or training facility, even when using a walking aid.<br>Example: the person is at significant risk of, or has frequent falls due to balance or other issues. |
| 30 | There is an extreme functional impact on activities using lower limbs.<br>(1) The person is unable to mobilise independently. |
Table 4 – Spinal Function
| Introduction to Table 4 |
| Table 4 is to be used to assess the functional impact of a diagnosed condition when performing activities involving spinal function, that is, bending or turning the back, trunk or neck.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purpose of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist confirming diagnosis of conditions commonly associated with spinal function impairment (such as spinal cord injury, spinal stenosis, cervical spondylosis, lumbar radiculopathy, herniated or ruptured disc, spinal cord tumours, arthritis or osteoporosis involving the spine, or chronic pain affecting the spine);a report from an allied health practitioner (such as a physiotherapist, or occupational therapist), confirming loss of range of movement in the spine or other effects of spinal disease or injury.<br>Restrictions on overhead tasks resulting from shoulder conditions should be rated under Table 2.Restrictions resulting from hip conditions should be rated under Table 3.Restrictions on lower limbs resulting from lumbar spine conditions, such as nerve pain and lower limb weakness, should be rated under Table 3.Upper or lower limb impairment resulting from a spinal condition such as nerve root compromise can be additionally assessed under Table 2 or Table 3 if the Table 4 rating does not fully account for the overall level of impairment.Where a person has nerve damage in an upper or lower limb or an impingement in the neck affecting the upper limbs, an additional rating on Table 2 or 3 can be considered.When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions such as chronic pain, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide.Assistance means assistance from another person rather than any aids or equipment the person may use, unless specified otherwise. |
| 0 | There is no or minimal functional impact on activities involving spinal function.<br>(1) The person can:<br>(a) bend down to pick a light object off the floor, such as a piece of paper; and<br>(b) turn their trunk from side to side; and<br>(c) turn their head to look to the sides or upwards. |
| 5 | There is a mild functional impact on activities involving spinal function.<br>(1) The person has mild difficulty in:<br>(a) activities over head height such as activities requiring the person to look upwards; or<br>(b) bending to knee level and straightening up again; or<br>Example: the person cannot bend down from a standing position to put on socks or shoes.<br>(c) turning their trunk or moving their head such as looking to the sides or upwards. |
| 10 | There is a moderate functional impact on activities involving spinal function.<br>(1) The person is able to sit in or drive a car for at least 30 minutes, and at least one of the following applies:<br>(a) the person has moderate difficulty sustaining overhead activities such as accessing items above head height; or<br>Example: looking up to hang washing on a clothesline.<br>(b) the person has moderate difficulty moving their head to look in all directions; or<br>Example: turning their head to look over their shoulder;<br>(c) the person has moderate difficulty bending forward to pick up a light object placed at knee height; or<br>(d) the person has moderate difficulty standing up from a sitting position in a standard chair without assistance.<br>Example: the person has moderate difficulty standing after being seated in a dining chair.<br> Note 1: this impairment rating level includes a person who can:<br>(a) move around independently using a wheelchair and can independently transfer to and from a wheelchair; or<br>Example: the person can use a wheelchair accessible toilet independently.<br>(b) move around independently using walking aids such as a quad stick, crutches or walking frame.<br>Note 2: the person may require additional time and effort to move around a workplace, may need to use accessible entries, lifts and toilets, and may not be able to access some areas of a workplace or training facility. |
| 20 | There is a severe functional impact on activities involving spinal function.<br>(1) The person has severe difficulty with at least one of the following:<br>(a) looking upwards to perform any overhead activities; or<br>(b) either turning their head, or bending their neck at all, without moving their trunk; or<br>(c) bending forward to hip height; or<br> Example: the person cannot bend forward to wipe a table or pick up a light object weighing less than 1kg from hip height.<br>(d) remaining seated for at least 10 minutes.<br>Example: the person frequently changes positions between sitting and standing or frequently shifts weight in a chair when seated.<br>Note: this impairment rating level includes a person who requires assistance to:<br>(a) move around in, or transfer to and from a wheelchair; or<br>Example: the person needs personal care assistance to use a toilet;<br>(b) move around using walking aids such as a quad stick, crutches or walking frame and the person requires assistance from another person to walk on some surfaces and cannot move independently around a workplace or training facility, even when using a walking aid.<br>Example: the person is at significant risk of, or has frequent falls due to balance or other issues. |
| 30 | There is an extreme functional impact on activities involving spinal function.<br>(1) The person cannot perform activities involving spinal function. |
Table 5 – Mental Health Function
| Introduction to Table 5 |
| Table 5 is to be used to assess the functional impact of a diagnosed mental health condition (including recurring episodes of mental health impairment).The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner (such as a general practitioner or a psychiatrist) with evidence from a registered psychologist (if the diagnosis has not been made by a psychiatrist).Diagnosis and evidence should make appropriate reference to the diagnostic tool used.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;supporting letters, reports or assessments relating to the person’s mental health or psychiatric condition;interviews with the person and those providing care or support to the person.<br>In using Table 5 evidence from a range of sources should be considered in determining which rating applies to the person being assessed.The person may not have sufficient self-awareness of their mental health impairment or may not be able to accurately describe its effects. This is to be kept in mind when discussing issues with the person and reading supporting evidence.The signs and symptoms of mental health impairment may vary over time. The person’s presentation on the day of the assessment should not solely be relied upon.When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not once or rarely.When assessing episodic or fluctuating impairments and conditions, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no or minimal functional impact on activities involving mental health function.<br>(1) The person has no or minimal difficulties with at least 4 of the following:<br>(a) self-care and independent living;<br>Example: the person lives independently and attends to all self-care needs without support.<br>(b) social/recreational activities and interpersonal relationships;<br>Example 1: the person goes out regularly to social and recreational events without support.<br>Example 2: the person has no or minimal difficulty forming and sustaining relationships.<br>(c) travel and accessing the community;<br>Example 1: the person is able to travel to and from unfamiliar environments independently.<br>Example 2: the person is able to utilise community facilities, such as local shops or other familiar venues.<br>(d) concentration and task completion;<br>Example 1: the person has no or minimal difficulties concentrating on most tasks.<br>Example 2: the person is able to complete a training or educational course or qualification in the normal timeframe.<br>(e) behaviour, planning and decision-making;<br>Example: the person has no or minimal difficulties in behaviour, planning or decision-making.<br>(f) work/training capacity.<br>Example 1: the person is able to cope with the normal demands of a job that is consistent with their education and training.<br>Example 2: the person is able to perform workplace tasks without posing a risk to the safety of themselves or co-workers due to ongoing mental illness. |
| 5 | There is a mild functional impact on activities involving mental health function.<br>(1) The person has mild difficulties with at least 4 of the following:<br>(a) self-care and independent living;<br>Example: the person lives independently but sometimes neglects self-care, grooming or meals.<br>(b) social/recreational activities and interpersonal relationships;<br>Example 1: the person is not actively involved when attending social or recreational activities.<br>Example 2: the person has interpersonal relationships that are strained, with occasional tension or arguments.<br>(c) travel and accessing the community;<br>Example 1: the person is sometimes reluctant to travel alone to unfamiliar environments.<br>Example 2: the person is sometimes reluctant to utilise community facilities such as local shops or other familiar venues.<br>(d) concentration and task completion;<br>Example 1: the person has mild difficulty focusing on complex tasks for more than 1 hour.<br>Example 2: the person has mild difficulties completing education or training.<br>(e) behaviour, planning and decision-making;<br>Example 1: the person has unusual behaviours that may disturb other people or attract negative attention and is sometimes more effusive, demanding or obsessive than is appropriate to the situation.<br>Example 2: the person has mild difficulties in planning and organising more complex activities.<br>(f) work/training capacity.<br>Example: the person has occasional interpersonal conflicts or poses some risk to the safety of themselves or co-workers due to ongoing mental illness at work, education or training that requires intervention by a supervisor, manager or teacher or changes in placement or groupings. |
| 10 | There is a moderate functional impact on activities involving mental health function.<br>(1) The person has moderate difficulties with at least 4 of the following:<br>(a) self-care and independent living;<br>Example: the person requires some support (that is, an occasional visit by or assistance from a family member or support worker) to live independently and maintain adequate hygiene and nutrition.<br>(b) social/recreational activities and interpersonal relationships;<br>Example 1: the person goes out alone infrequently and is not actively involved in social events.<br>Example 2: the person has moderate difficulty making and keeping friends or sustaining relationships.<br>(c) travel and accessing the community;<br>Example 1: the person will often avoid travelling alone to unfamiliar environments.<br> Example 2: the person will often avoid utilising community facilities such as local shops or other familiar venues.<br>(d) concentration and task completion;<br>Example 1: the person has moderate difficulty concentrating on longer tasks, and following along with the task, for more than 30 minutes (such as reading an article, watching a television program or playing a video game).<br>Example 2: the person has moderate difficulty following complex instructions (such as from an operating manual, recipe or assembly instructions).<br>(e) behaviour, planning and decision-making;<br>Example 1: the person has moderate difficulty coping with situations involving stress, pressure or performance demands.<br>Example 2: the person has occasional behavioural or mood difficulties (such as temper outbursts, depression, withdrawal or poor judgement).<br>Example 3: the person’s activity levels are noticeably increased or reduced.<br>(f) work/training capacity.<br>Example: the person often has interpersonal conflicts or poses a risk to themselves or co-workers due to ongoing mental illness at work, education or training that requires intervention by supervisors, managers or teachers or changes in placement or groupings. |
| 20 | There is a severe functional impact on activities involving mental health function.<br>(1) The person has severe difficulties with at least 4 of the following:<br>(a) self-care and independent living;<br>Example: the person requires regular support to live independently, that is, needs visits or assistance at least twice a week from a family member, friend, health worker or support worker<br>(b) social/recreational activities and interpersonal relationships;<br>Example 1: the person has very limited social contacts and involvement unless these are organised for the person.<br>Example 2: the person often has severe difficulty interacting with other people and usually needs assistance or support from a companion to engage in social interactions.<br>(c) travel and accessing the community;<br>Example 1: the person travels alone only in familiar areas (such as the local shops or other familiar venues).<br>Example 2: the person usually avoids utilising community facilities such as public transport.<br>(d) concentration and task completion;<br>Example 1: the person has severe difficulty concentrating on or following along with any task or conversation for more than 10 minutes.<br>Example 2: the person has slowed movements or reaction time due to psychiatric illness or treatment effects.<br>(e) behaviour, planning and decision-making;<br>Example: the person’s behaviour, thoughts and conversation are significantly and frequently disturbed.<br>(f) work/training capacity.<br>Example: the person has severe difficulty attending work, education or training on a regular basis over a lengthy period due to ongoing mental illness. |
| 30 | There is an extreme functional impact on activities involving mental health function.<br>(1) The person has extreme difficulties with at least 4 of the following:<br>(a) self-care and independent living;<br>Example 1: the person requires continual support with daily activities and self-care.<br>Example 2: the person is unable to live on their own and lives with family or in a supported residential facility or similar, or in a secure facility.<br>(b) social/recreational activities and interpersonal relationships;<br>Example: the person has extreme difficulty interacting with other people and is socially isolated.<br>(c) travel and accessing the community;<br>Example: the person is unable to travel away from their own residence without a support person.<br>(d) concentration and task completion;<br>Example 1: the person has extreme difficulty in concentrating on or following along with any productive task for more than a few minutes.<br>Example 2: the person has extreme difficulty in completing tasks or following instructions.<br>(e) behaviour, planning and decision-making;<br>Example 1: the person has extremely disturbed behaviour which may include self-harm, suicide attempts, unprovoked aggression towards others or manic excitement.<br>Example 2: the person’s judgement, decision-making, planning and organisation functions are severely disturbed.<br>(f) work/training capacity.<br>Example: the person is unable to attend work, education or training sessions other than for short periods of time due to ongoing mental illness. |
Table 6 – Functioning related to Alcohol, Drug and Other Substance Use
| Introduction to Table 6 |
| Table 6 is to be used to assess the functional impact of a diagnosed condition resulting from excessive use of alcohol, drugs or other harmful substances (such as glue or petrol) or the misuse of prescription drugs.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner. For example a general practitioner or medical specialist such as an addiction medicine specialist, or psychiatrist with experience in diagnosis of substance use disorders.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.This Table applies to people who have current, continuing substance use disorders and those in receipt of alcohol or other drug treatment.People with a past history of substance use disorder with resulting long-term impairments should be assessed under the relevant Table(s).<br>Example 1: Table 7 should be used where the person has neurological impairment resulting from previous alcohol, drug or other harmful substance use.<br>Example 2: Table 5 should be used where the person suffers a mental health impairment resulting from previous alcohol, drug or other harmful substance use. The use of drugs or alcohol does not in itself constitute or necessarily indicate a functional impairment.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;supporting letters, reports or assessments relating to the person’s substance use disorder;a report from a medical specialist (such as a general practitioner, addiction medicine specialist or psychiatrist with experience in diagnosis or treatment of substance use disorders) confirming diagnosis of substance use disorder and resulting impairment of other body systems or functions;a report from an allied health practitioner (such as a psychologist) confirming the person’s functional impairment;results of investigations (such as liver function tests, alcohol and substance use assessment scales);interviews with the person and those who provide care or support to the person;reports or other records of participation in treatment programs;work or training attendance records.<br> <br>In using Table 6, evidence from a range of sources should be considered in determining which rating applies to the person being assessed.The person may not have sufficient self-awareness of their substance use disorder or may not be able to accurately describe its effects. This is to be kept in mind when discussing issues with the person and reading supporting evidence.The signs and symptoms of substance use disorder may vary over time. The person’s presentation on the day of the assessment should not be solely relied upon.When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no or minimal functional impact from alcohol, drugs or other harmful substance use.<br> <br>(1) The person has no or minimal difficulties attending to all aspects of self-care and daily living tasks, and is able to attend and effectively participate in work, education and training activities. |
| 5 | There is mild functional impact from alcohol, drugs or other harmful substance use.<br> <br>(1) As a result of a person’s substance use disorder they experience at least one of the following:<br> <br>(a) mild physical or cognitive effects that carry over into working hours; or<br>Example: the person occasionally experiences poor concentration, lethargy or irritability, which affects their ability to focus on and complete tasks due to the effects of their substance use.<br> <br>(b) occasional difficulties in reliably attending work, education or training sessions or appointments or completing duties or assigned tasks; or<br>Example: the person is occasionally late to work and does not perform tasks at expected capacity due to the effects of their substance use.<br> <br>(c) infrequent absences from work, education or training activities.<br>Example: the person takes occasional days off work due to the effects of their substance use. |
| 10 | There is moderate functional impact from alcohol, drugs or other harmful substance use.<br> <br>(1) As a result of a person’s substance use disorder they experience at least 3 of the following:<br> <br>(a) moderate difficulties performing physical or cognitive tasks;<br>Example: the person regularly experiences poor concentration, lethargy or irritability, which affects their ability to focus on and complete tasks due to the effects of their substance use.<br>(b) moderate difficulties in maintaining self-care, hygiene, nutrition and general health;<br>Example: the person regularly prioritises activities associated with their substance use over self-care activities, such as showering and eating meals.<br>(c) moderate difficulties with family or social relationships and activities;<br>Example 1: the person has moderate difficulties sustaining relationships with family or making and keeping friends not associated with their substance use.<br>Example 2: the person has interpersonal relationships that are strained, often with tension or arguments related to the person’s substance use.<br>(d) moderate difficulties in reliably attending appointments or completing duties or assigned tasks;<br>Example: the person is regularly late to engagements, neglects tasks or financial obligations or requires more than the usual prompts and assistance to complete tasks.<br>(e) is often absent from work, education or training activities.<br>Example: the person takes regular days off work due to the effects of their substance use. |
| 20 | There is severe functional impact from alcohol, drug or other harmful substance use.<br> <br>(1) As a result of a person’s substance use disorder they experience at least 3 of the following:<br> <br>(a) severe difficulties in maintaining self-care, hygiene, nutrition and general health;<br>Example: the person frequently neglects self-care activities, such as showering, washing clothes and eating meals as a result of their substance use.<br>(b) severe difficulties in prioritising activities that are not related to the procurement or use of a substance, despite harm or negative consequences;<br>Example 1: the person prioritises purchasing substances of purchasing necessities, such as food. <br>Example 2: the person engages in harmful substance use behaviour despite severe health consequences.<br>(c) severe physical or cognitive impairment resulting from chronic and ongoing use of a substance;<br>Example: the person has a diagnosed condition, such as end organ damage, psychological or psychiatric assessment showing sustained and significant impairment or behavioural dysfunction linked to brain damage resulting from their substance use.<br>(d) severe difficulties in withdrawing from a substance or avoiding harmful use of a substance;<br>Example 1: the person experiences brief or limited periods of remission, if it occurs at all.<br>Example 2: the person experiences severe withdrawal symptoms, such as seizures, when they abstain from substance use.<br>(e) frequent absences from work, education or training activities<br>Example 1: the person is rarely able to attend work due to the ongoing effects of substance use.<br>Example 2: the person has severe difficulty sustaining employment due to the potential harm to self or others, including aggressive or risky behaviours. |
| 30 | There is an extreme functional impact from alcohol, drug or other harmful substance use.<br> <br>(1) As a result of a person’s substance use disorder they experience at least 3 of the following:<br>(a) extreme difficulties in maintaining personal care, hygiene, nutrition and general health;<br>Example: the person has extreme difficulties undertaking any self-care activities as a result of their substance use.<br>(b) extreme physical or cognitive impairment resulting from chronic and ongoing use of a substance;<br>Example: the person has sustained irreparable damage to their physical health, such as failure of the liver or other organs, or brain injury with severely impaired cognitive function as a result of their substance use.<br>(c) extreme difficulties with most aspects of relationships, social interaction and community involvement;<br>Example: the person is socially isolated, unless they are interacting with people related to their substance use.<br>(d) extreme difficulties in withdrawing from or avoiding harmful use of a substance and unable to attend work or activities.<br>Example: the person is unable to withdraw from a substance due to their dependence on the substance. |
Table 7 – Brain Function
| Introduction to Table 7 |
| Table 7 is to be used to assess the functional impact of a diagnosed condition related to neurological or cognitive function.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a specialist health practitioner supporting the diagnosis of conditions associated with neurological or cognitive impairment such as an acquired brain injury, stroke (cerebrovascular accident (CVA)), conditions resulting in dementia, tumour in the brain, some neurodegenerative disorders, chronic pain, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD);results of diagnostic tests (such as Magnetic Resonance Imagery (MRI), Computerised (Axial) Tomography (CT) scans, Electroencephalography (EEG));results of cognitive function assessments;interviews with the person and those providing care or support to the person.<br>The person may not have sufficient self-awareness of their cognitive function or may not be able to accurately describe its effects. This is to be kept in mind when discussing issues with the person and reading supporting evidence.The signs and symptoms of neurological or cognitive impairment may vary over time. The person’s presentation on the day of the assessment cannot solely be relied upon.A person with autism spectrum disorder (ASD) or fetal alcohol spectrum disorder (FASD) who does not have a meaningful intelligence quotient (IQ) between 70-85, can be assessed under this Table.Table 7 cannot be used when a person has an impairment of intellectual function already assessed under Table 9, unless the person has an additional condition affecting neurological or cognitive function.When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide.Assistance means assistance from another person rather than any aids or equipment the person may use, unless specified otherwise. |
Points Descriptors
0 There is no or minimal functional impact resulting from a neurological or cognitive condition. (1) The person has no significant problems with memory, attention, concentration, problem solving and cognitive flexibility, visuo-spatial function, planning, decision making, comprehension, self-awareness, social skills or behavioural regulation.
5 There is a mild functional impact resulting from a neurological or cognitive condition.(1) The person is able to complete most activities of daily living without assistance and has mild difficulties in at least 2 of the following:(a) memory;Example: the person occasionally forgets to complete a regular task or sometimes misplaces important items.(b) attention and concentration;Example 1: the person has mild difficulty concentrating on tasks for more than 1 hour.Example 2: the person has mild difficulty focusing on a task if there are other activities occurring nearby.Example 3: the person has mild difficulty with concentration due to sensitivity to sensory input, including environmental stimuli from any of the senses.(c) problem solving and cognitive flexibility;Example 1: the person has mild difficulty solving problems that may involve multiple factors or abstract concepts.Example 2: the person shows a lack of awareness of problems in some situations.Example 3: the person has mild difficulty considering the point of view of others or coping with changes to their daily routine if not provided with warning in advance, which may result in strained relationships with occasional tension or arguments. (d) planning;Example: the person has mild difficulty planning and organising activities such as arranging travel and accommodation for an interstate or overseas holiday.(e) decision making;Example: the person has mild difficulty in prioritising and decision making when there are several options to choose from.(f) comprehension;Example: the person has mild difficulty in understanding instructions involving multiple steps.(g) visuo-spatial function;Example: the person has mild difficulty with visuo-spatial functions such as distance and depth perception when driving and parking a car.(h) behavioural regulation;Example 1: the person exhibits temper outbursts, withdrawal or effusiveness without significant adverse consequences.Example 2: the person sometimes demonstrates behavioural dysregulation that is mildly self-limiting and/or impactful on others, such as mild difficulty engaging in non-preferred environments, or self-stimulatory behaviour (stimming) in a familiar setting. (i) social skills;Example: the person has mild difficulty reading non-verbal communication such as gestures or facial expressions, has mild difficulty interacting with others and shows a lack of awareness of social norms and expectations.(j) self-awareness.Example 1: the person has mild difficulty in recognising and responding to social cues and the person appears less engaged or inappropriately engaged.Example 2: the person exhibits disinhibited behaviour resulting in awkwardness with social interactions.
10 There is a moderate functional impact resulting from a neurological or cognitive condition.(1) The person requires occasional (less than once a day) assistance with activities of daily living and has moderate difficulties in at least 2 of the following:(a) memory;Example 1: the person often forgets to complete regular tasks such as putting the bin out on rubbish night.Example 2: the person often misplaces items.Example 3: the person requires memory aids such as shopping lists to remember any more than 3 or 4 items.(b) attention and concentration;Example 1: the person has moderate difficulty concentrating on tasks for more than 30 minutes.Example 2: the person experiences moderate difficulty focusing on a task due to distraction or overstimulation from sensory input including environmental stimuli from any of the senses. (c) problem solving and cognitive flexibility;Example 1: the person has moderate difficulty solving some day-to-day problems or problems not previously encountered and may require assistance or advice from time to time.Example 2: the person has moderate difficulty coping with changes in routine, even when provided with warning about the upcoming change or difficulty switching between activities or prioritising required tasks.(d) planning;Example: the person has moderate difficulty planning and organising new or special activities such as planning and organising a large birthday party.(e) decision making;Example: the person has moderate difficulty in prioritising and decision making and displays poor judgement at times, resulting in negative outcomes for self or others.(f) comprehension;Example: the person has moderate difficulty understanding instructions involving multiple steps and may require more prompts, written instructions or repeated demonstrations than peers to complete tasks.(g) visuo-spatial function;Example: the person has moderate difficulty with visuo-spatial functions such as difficulty reading maps, giving directions or judging distance or depth but this does not result in major limitations in activities of daily living.(h) behavioural regulation;Example 1: the person occasionally (less than once a week) has moderate difficulty controlling behaviour in routine situations such as showing frustration or anger or losing temper for minor reasons but displays no physical aggression.Example 2: the person occasionally (less than once a day) demonstrates behavioural dysregulation that is moderately self-limiting and or/impactful on others, such as moderate difficulty or refusal to engage in non-preferred environments, or self‑stimulatory behaviour (stimming) around unfamiliar people or environments.(i) social skills;Example: the person has moderate difficulty reading non-verbal communication such as gestures or facial expressions, has moderate difficulty interacting with others and shows a lack of awareness of social norms and expectations.(j) self-awareness.Example: the person lacks awareness of own limitations, resulting in moderate difficulties in social interactions or problems arising in activities of daily living.
20 There is a severe functional impact resulting from a neurological or cognitive condition.(1) The person requires frequent (at least once a day) interactive assistance and supervision and has severe difficulties in at least 2 of the following:(a) memory;Example 1: the person has severe difficulty remembering routines, regular tasks and instructions.Example 2: the person has severe difficulty recalling events of the past few days.Example 3: the person gets easily lost in unfamiliar places.(b) attention and concentration;Example 1: the person has severe difficulty concentrating on any task, even a task that interests the person, for more than 10 minutes.Example 2: the person has severe distress from sensory input, including environmental stimuli from any of the senses.(c) problem solving and cognitive flexibility;Example 1: the person has severe difficulty solving routine day-to-day problems (such as what to do if a household appliance breaks down) and needs regular assistance and advice.Example 2: even when provided with support about an upcoming change, the person has severe difficulty coping with changes in routine, or experiences distress with changing focus or activities.(d) planning;Example: the person has severe difficulty planning and organising routine daily activities (such as an outing to the movies or a supermarket shopping trip).(e) decision making;Example: the person has severe difficulty prioritising and making simple decisions and often displays poor judgement, resulting in negative outcomes for self or others.(f) comprehension;Example: the person has severe difficulty understanding basic instructions and needs regular prompts to complete tasks.(g) visuo-spatial function;Example: the person has severe difficulty performing many visuo-spatial functions (such as following or giving simple directions (including to the person’s house) or judging distance or depth (resulting in stumbling on steps or bumping into objects)).(h) behavioural regulation;Example 1: the person often (more than once a week) has severe difficulty controlling behaviour even in routine, day-to-day situations and may be verbally abusive to others or threaten physical aggression.Example 2: the person frequently (at least once a day) demonstrates behavioural dysregulation that is severely self-limiting and /or impactful on others such as severe difficulty or refusal to engage in non-preferred environments, or self-stimulatory behaviour in most environments.(i) social skills;Example: the person has severe difficulty reading non-verbal communication (such as gestures or facial expressions), has severe difficulty interacting with others and shows a lack of awareness of social norms and expectations.(j) self-awareness.Example: the person lacks awareness of own limitations, resulting in severe difficulties in social interactions or problems arising in activities of daily living.
30 There is an extreme functional impact resulting from a neurological or cognitive condition.(1) The person requires continual interactive assistance and supervision and has extreme difficulties in at least 2 of the following:(a) memory;Example 1: the person requires constant prompts and reminders to remember routine tasks, familiar people and places and may get lost even in familiar places if not accompanied.Example 2: the person has extreme difficulty remembering events that happened earlier in the day (such as what the person ate for breakfast).(b) attention and concentration;Example: the person has extreme difficulty concentrating on any task for more than a few minutes which may be due to sensory input, including environmental stimuli from any of the senses.(c) problem solving and cognitive flexibility;Example 1: the person has extreme difficulty solving even the most basic problems (such as what to do if the kettle is empty) and needs complete assistance with problem solving.Example 2: the person has extreme difficulty coping with changes in routine, or experiences restricted behaviours resulting in extreme distress with changing focus or activities. (d) planning;Example: the person has extreme difficulty planning and organising daily activities and needs complete assistance to organise daily routine.(e) decision making;Example: the person has extreme difficulty prioritising and making simple decisions and needs substantial support from a guardian or other delegate to make decisions or give consent on the person’s behalf.(f) comprehension;Example: the person has extreme difficulty understanding even simple, single step instructions and needs assistance to complete most tasks.(g) visuo-spatial function;Example 1: the person has extreme difficulty performing even basic visuo-spatial functions, following spatial directions (such as ‘turn left at the corner’), or judging distance or depth which severely limits mobility.Example 2: the person has left or right-sided neglect, that is, they are not aware of objects, people or body parts in the left or right field of vision. This means that even though the person’s eyes can see an object, the person’s brain does not register its presence.(h) behavioural regulation;Example 1: the person has extreme difficulty controlling behaviour in a range of day‑to‑day situations and this interferes with participation in activities outside the home and requires supervision and possibly restriction to a home or institutional environment.Example 2: the person constantly demonstrates behavioural dysregulation that is extremely self-limiting and/or impactful on others, such as extreme difficulty or refusal to engage in non-preferred environments, or self-stimulatory behaviour in all environments.(i) social skillsExample: the person has extreme difficulty reading non-verbal communication (such as gestures or facial expressions), interacting with others and shows a lack of awareness of social norms and expectations.(j) self-awareness.Example: the person has very poor or no awareness of own limitations resulting in frequent and serious risks to self or others.
Table 8 – Communication Function
| Introduction to Table 8 |
| Table 8 is to be used to assess the functional impact of a diagnosed condition affecting communication functions.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.In this Table, communication may be verbal or in conjunction with alternative or augmentative communication systems (such as sign language, which may be a recognised sign language such as Auslan, electronic speech, communication symbols, writing or other non-verbal communication methods).There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a specialist assessment by a speech pathologist, neurologist or psychologist;a report from a medical specialist confirming diagnosis of conditions associated with communication impairment (such as stroke (cerebrovascular accident (CVA)), other acquired brain injury, head, neck or throat cancer, cerebral palsy, neurodegenerative conditions, or damage to the speech-related structures of the mouth, vocal cords or larynx);results of diagnostic tests (such as X-Rays or other imagery);results of functional assessments.<br>If the person uses recognised sign language or other non-verbal communication method as a result of hearing loss only, the person’s hearing and communication function should be assessed using Table 11.If the impairment affecting communication function is due to impairment in intellectual function, only Table 9 must be used.In this Table, main language means the language that the person most commonly uses.In this Table, communication or communication functions means receptive communication (understanding language) or expressive communication (producing speech).When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.Assistance means assistance from another person rather than any aids or equipment the person may use, unless specified otherwise.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no or minimal functional impact on communication in the person’s main language.<br>(1) The person’s speech is usually understood by those who speak the same language and has no difficulty understanding or engaging in meaningful conversation. |
| 5 | There is a mild functional impact on communication in the person’s main language.<br>(1) At least one of the following applies:<br>(a) the person has mild difficulty understanding complex words and long sentences such as a complex news article; or<br>(b) the person has mild difficulty in producing speech and has mild difficulty with being understood due to content or speech production arising from, for example a stutter or stammer, or vocal cord, larynx damage. |
| 10 | There is a moderate functional impact on communication in the person’s main language.<br>(1) At least one of the following applies:<br>(a) the person:<br>(i) has moderate difficulty understanding day-to-day language, particularly where a sentence or instruction includes multiple steps or concepts such as ‘Please take this book out to Jane at the front desk and ask her to give you some paper clips and bring them back in here’; or<br>(ii) may need instructions repeated or broken down into shorter sentences; or<br>(b) the person has moderate difficulty in producing speech, difficulty coordinating speech movements or damage to speech structures arising from, for example a stutter or stammer, or vocal cord, larynx damage, which makes speech effortful, slow or sometimes difficult for unfamiliar people to understand; or<br>(c) the person uses alternative or augmentative communication such as sign language, technology that produces electronic speech, use of symbols to communicate and has moderate difficulty speaking clearly and may be partially reliant on a recognised sign language such as Auslan or signed English or other non‑verbal communication methods. |
| 20 | There is a severe functional impact on communication in the person’s main language.<br>(1) Either:<br>(a) the person has severe difficulty understanding day-to-day language in unfamiliar environments or relating to non-routine tasks, even where a sentence or instruction includes only a single step such as ‘put the book next to the pencils’ and needs instructions repeated or gestures or physical demonstration in order to understand; or<br>(b) at least one of the following applies:<br>(i) the person has severe difficulty in producing speech, difficulty coordinating speech movements or damage to speech structures, for example a stutter or stammer, or vocal cord, larynx damage which makes speech very effortful or very slow; or<br>(ii) the person’s speech is difficult for strangers to understand; or<br>(iii) the person uses a limited vocabulary of words in speech; or<br>Example: fewer than 50 words;<br>(iv) the person’s speech is clear but is not used appropriately, such as frequent echolalia - compulsively repeats words or what the other person says, frequently swears or uses abusive language as a result of a condition such as Tourette syndrome and has severe difficulty sustaining a normal conversation for even a few minutes; or<br>(2) The person uses alternative or augmentative communication such as sign language, technology that produces electronic speech, use of symbols to communicate, use of a note taker to assist in communication; and<br>(a) the person has severe difficulty speaking clearly and is completely reliant on a recognised sign language such as Auslan or signed English; or<br>(b) the person needs to use an electronic communication device to communicate with others in places such as shops, workplace, education or training facility and cannot be understood without this device; or<br>(c) the person has severe difficulty speaking and uses handwriting or typing to communicate; or<br>(d) the person has severe difficulty speaking and uses the assistance of a note taker to communicate. |
| 30 | There is extreme functional impact on communication in the person’s main language.<br>(1) Either:<br>(a) the person:<br>(i) has extreme difficulty understanding even simple day‑to-day language in familiar environments; or<br>(ii) may understand only a few single words or simple phrases that are used on a regular basis such as ‘drink’, ‘toilet’, ‘bed-time’, ‘go in the car’; or<br>(iii) needs additional gestures, pictures, symbols or physical demonstration in order to understand what is said; or<br>(b) at least one of the following applies:<br>(i) the person has extreme difficulty in producing any clear speech or is unable to speak at all; or<br>(ii) the person’s speech is difficult to understand even for family members and others who have regular contact with the person; or<br>(iii) the person uses a limited vocabulary of words in speech; or<br>Example: fewer than 20 words.<br>(iv) the person is only able to indicate yes or no, pleasure or displeasure through facial expressions, head movements or hand or body gestures; or<br>(2) The person uses alternative or augmentative communication such as sign language, technology that produces electronic speech, use of symbols to communicate, use of a note taker to communicate; and<br>(a) the person uses a limited number of symbols such as Compics or pictures or photos to communicate basic needs and feelings; or<br>(b) the person needs to use an electronic communication device to communicate with others but has difficulty using this and is very slow in preparing communications; or<br>(c) the person is unable to speak or use an electronic communication device and uses a note taker to communicate with others. |
Table 9 – Intellectual Function
| Introduction to Table 9 |
| Table 9 is to be used to assess the functional impact of a diagnosed condition resulting in low intellectual function (a meaningful intelligence quotient (IQ) score of 70 to 85), which originated before the person turned 18 years of age.An assessment of the condition causing the impairment must be made by an appropriately qualified psychologist.An assessment of intellectual functioning and adaptive behaviour is to be undertaken in the form of an individually administered and psychometrically valid, comprehensive, culturally appropriate and psychometrically sound standardised assessment that:<br>provides robust standardised scores and a percentile ranking;demonstrates test validity and reliability based on current norms developed on a representative sample of the general population.<br>Consideration of the adaptation of recognised assessments of intellectual function for use with Aboriginal and Torres Strait Islander peoples is required.There must be corroborating evidence of the person’s impairment.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;supporting letters, reports or assessments relating to the person’s development, intellectual function, adaptive behaviour or participation in programs;interviews with the person and those providing care, support or treatment to the person.<br>A person with autism spectrum disorder (ASD), or fetal alcohol spectrum disorder (FASD) who also has a meaningful IQ score ranging from 70-85 should be assessed under this Table.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no or minimal impact on adaptive functioning.<br>(1) At least one of the following applies:<br>(a) The person is assessed as having a score of adaptive behaviour of 90 or above, on an adaptive behaviour scale; or<br> (b) The person is assessed as being within the percentile rank of 24 or above on a standardised assessment of adaptive behaviour. |
| 5 | There is mild impact on adaptive functioning.<br>(1) At least one of the following applies:<br>(a) The person is assessed as having a score of adaptive behaviour between 80 to 89, on an adaptive behaviour scale; or<br> (b) The person is assessed as being within the percentile rank of 9 to 23 on a standardised assessment of adaptive behaviour. |
| 10 | There is moderate impact on adaptive functioning.<br>(1) At least one of the following applies:<br>(a) The person is assessed as having a score of adaptive behaviour between 71 to 79, on an adaptive behaviour scale; or<br> (b) The person is assessed as being within the percentile rank of 3 to 8 on a standardised assessment of adaptive behaviour. |
| 20 | There is severe impact on adaptive functioning.<br>(1) At least one of the following applies:<br>(a) The person is assessed as having a score of adaptive behaviour of between 51 to 70 on an adaptive behaviour scale; or<br> (b) The person is assessed as being within the percentile rank of 0.1 to 2 on a standardised assessment of adaptive behaviour. |
| 30 | There is an extreme impact on adaptive functioning.<br>(1) At least one of the following applies:<br>(a) The person is assessed as having a score of adaptive behaviour of 50 or less on an adaptive behaviour scale; or<br> (b) The person is assessed as being within the percentile rank of less than 0.1 on a standardised assessment of adaptive behaviour. |
Table 10 – Digestive and Reproductive Function
| Introduction to Table 10 |
| Table 10 is to be used to assess the functional impairment of a diagnosed condition related to digestive or reproductive system functions.Digestive conditions may include cancer and other diseases that affect the mouth, salivary glands, oesophagus, stomach, intestines (small or large intestine), pancreas, liver, gall bladder, bile ducts, rectum or anus.Reproductive system conditions may include gynaecological diseases (such as severe and intractable endometriosis, ovarian cancer, cervical cancer, endometrial cancers) and conditions of the male reproductive system (such as prostate cancer).The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist (such as a gastroenterologist, a gynaecologist, an urologist or an oncologist) confirming diagnosis of a digestive or reproductive system condition;results of investigations (such as X-Rays or other imagery, endoscopy or colonoscopy).<br>Personal care needs associated with digestive conditions include, but are not limited to, the need to take medications when symptoms occur, care of special feeding equipment (such as Percutaneous Endoscopic Gastrostomy (PEG) button or special feeding tube), special diets or feeding solutions, strategies to relieve chronic pain, additional toileting and personal hygiene needs.Personal care needs associated with reproductive system conditions include, but are not limited to, strategies to relieve chronic pain or more frequent menstrual care.When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no or minimal functional impact from symptoms associated with a digestive or reproductive system condition.<br>(1) The person is not usually interrupted at work or other activity by symptoms or personal care needs associated with a digestive or reproductive system condition. |
| 5 | There is a mild functional impact from symptoms associated with a digestive or reproductive system condition.<br>(1) At least one of the following applies:<br>(a) the person’s attention and concentration at a task are sometimes (on most days) interrupted or reduced by chronic pain or other symptoms or personal care needs associated with the digestive or reproductive system condition; or<br>(b) the person is sometimes (less than once per month) absent from work, education or training activities due to the digestive or reproductive system condition. |
| 10 | There is a moderate functional impact from symptoms associated with a digestive or reproductive system condition.<br>(1) At least 2 of the following apply to the person:<br>(a) the person’s attention and concentration on a task are often (at least once a day but not every hour) interrupted or reduced by chronic pain or other symptoms or personal care needs associated with the digestive or reproductive system condition;<br>(b) the person has moderate difficulty sustaining work activities or other tasks for more than 2 hours without a break due to symptoms of the digestive or reproductive system condition;<br>(c) the person is often (once per month) absent from work, education or training activities due to the digestive or reproductive system condition. |
| 20 | There is a severe functional impact from symptoms associated with a digestive or reproductive system condition.<br>(1) At least 2 of the following apply to the person:<br>(a) the person’s attention and concentration at a task is frequently (at least once every hour) interrupted or reduced by chronic pain or other symptoms or personal care needs associated with the digestive or reproductive system condition;<br>(b) the person has severe difficulty sustaining work activities or other tasks for a total of more than 3 hours a day, even with regular breaks, due to symptoms of the digestive or reproductive system condition;<br>(c) the person has severe difficulty travelling to or participating in community or social environments due to symptoms or management of the gastrointestinal or reproductive system functions, causing frequent disruption to daily activities due to avoidance of activities;<br>Example: the person avoids using lifts, public transport or being near others due to the nature of their condition.<br>(d) the person is frequently (twice or more per month) absent from work, education or training activities due to the digestive or reproductive system condition. |
| 30 | There is an extreme functional impact from symptoms associated with a digestive or reproductive system condition.<br>(1) At least 2 of the following apply to the person:<br>(a) the person’s attention and concentration at a task are continually interrupted or reduced by chronic pain or other symptoms or care needs associated with the digestive or reproductive system condition (such that pain or other symptoms are present all or most of the time);<br>(b) the person is unable to sustain work activity or other tasks for more than one hour without a break due to symptoms of the digestive or reproductive system condition;<br>(c) the person has extreme difficulty travelling to or being in social environments due to symptoms or management of the gastrointestinal or reproductive system functions, causing extreme disruption to daily activities and rarely engages in activities outside of the home;<br>(d) the person is rarely able to attend work, education or training activities due to the digestive or reproductive system condition. |
Table 11 – Hearing and other Functions of the Ear
| Introduction to Table 11 |
| Table 11 is to be used to assess the functional impact of a diagnosed condition when performing activities involving hearing function or other functions of the ear (such as balance).The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner with corroborating evidence from an audiologist, neurosurgeon, neurologist or Ear, Nose and Throat (ENT) specialist.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist (such as an ENT specialist, neurologist or neurosurgeon) confirming diagnosis of conditions associated with hearing impairment or other impaired function of the ear (such as congenital deafness, presbyacusis, acoustic neuroma, head or neck cancer, side-effects of medication including chemotherapy, Meniere's disease or neurological conditions);results of audiological assessment undertaken by a fully qualified audiologist, audiometrist or ENT specialist.<br>Table 11 should be applied with the person using any prescribed hearing aid, cochlear implant or other assistive listening device that they usually use.If the person uses recognised sign language or other non-verbal communication method as a result of hearing loss only, the person’s hearing and communication function should be assessed using Table 11.When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would normally be expected to do so and not only once, or rarely.When assessing episodic or fluctuating impairments and conditions, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no or minimal functional impact on activities involving hearing function or other functions of the ear.<br>(1) The person:<br>(a) can hear a conversation at average volume in a room with an average level of background noise, such as other people talking quietly in the background; and<br>(b) does not have difficulty with balance, dizziness or ringing in the ears. |
| 5 | There is mild functional impact on activities involving hearing function or other functions of the ear.<br>(1) The person:<br>(a) has mild difficulty hearing a conversation at an average volume in a room with background noise, such as other people talking quietly in the background; and<br>(b) has mild difficulty hearing conversations when using a standard telephone, particularly in a room with background noise; or<br>(2) The person has occasional difficulty with balance, such as occasional dizziness, or ringing in the ears, which occasionally interferes with communication ability or routine activities due to a medically diagnosed disorder of the inner ear, such as Meniere’s disease. |
| 10 | There is a moderate functional impact on activities involving hearing function or other functions of the ear.<br>(1) The person:<br>(a) has moderate difficulty hearing a conversation at average volume in a room with no background noise; and<br>(b) the person has occasional difficulty with some words; and<br>(c) is partially reliant on lip-reading or a recognised sign language, such as Auslan, that is, the person needs to lip-read or watch a sign language interpreter in some situations where background noise is present or needs to have parts of conversations clarified or repeated using lip-reading or recognised sign language; or<br>(2) The person has more frequent difficulty with balance, such as having dizziness or having to sit down or hold on to a solid object, or ringing in the ears which interferes with communication ability or routine activities, due to a medically diagnosed disorder of the inner ear, such as Meniere’s disease. |
| 20 | There is a severe functional impact on activities involving hearing function or other functions of the ear.<br>(1) The person:<br>(a) has severe difficulty hearing any conversation even at raised volume in a room with no background noise such as someone speaking to them in a loud voice shouting a warning, such as ‘Look out!’; and<br>(b) has severe difficulty hearing sounds needed for personal or workplace safety, such as a smoke alarm, fire evacuation siren, or car or truck horn; and<br>(c) is reliant on captions to follow a television program or movie; and<br>(d) is completely reliant in all situations on a recognised sign language, such as Auslan, lip reading, other non-verbal communication method, such as note taking, to converse with others; or<br>(2) The person has continual difficulty with balance, such as having continual dizziness or having to sit down or hold on to a solid object, or continual ringing in the ears that interferes with hearing, due to a medically diagnosed disorder of the inner ear, such as Meniere’s disease. |
| 30 | There is an extreme functional impact on activities involving hearing function or other functions of the ear.<br>(1) The person:<br>(a) is unable to hear anything at all; and<br>(b) has limited or no ability to understand a recognised sign language, such as Auslan, lip reading, or other non-verbal communication methods, such as written notes; and<br>(c) is unable to sustain an upright posture due to extreme difficulty with balance. |
Table 12 – Visual Function
| Introduction to Table 12 |
| Table 12 is to be to assess the functional impact of a diagnosed condition when performing activities involving visual function.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner with corroborating evidence from an ophthalmologist, optometrist, neurosurgeon or neurologist.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist (such as ophthalmologist or ophthalmic surgeon) confirming diagnosis of conditions associated with vision impairment (such as diabetic retinopathy, brain tumours, glaucoma, retinitis pigmentosa, macular degeneration, cataracts or congenital visual impairment);results of vision assessments (such as assessments done by an optometrist).<br>Table 12 should be applied with the person using any visual aids the person usually uses, such as spectacles or contact lenses.Where severe or extreme loss of visual function is evident or suspected, it is to be recommended that assessment by a qualified ophthalmologist occur to determine if the person meets the criteria for permanent blindness.Assistance means assistance from another person, rather than any aids, equipment or assistive technology the person may use, unless specified otherwise.When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no or minimal functional impact on activities involving visual function.<br>(1) The person has no or minimal difficulties seeing things at a distance or close up and all of the following apply:<br>(a) the person has no or minimal difficulties seeing the print in a newspaper or magazine;<br>(b) the person has no or minimal difficulties seeing road signs, street signs or bus numbers;<br>(c) the person has a full field of vision, that is, they have no or minimal difficulties with peripheral vision (being aware of objects or movement to the sides, above or below, when looking straight ahead) and no patches or areas of lost vision;<br>(d) the person can usually perform all day-to-day functions involving the eyes with no or minimal discomfort, such as no or minimal watering of the eyes, difficulty opening the eyes, or difficulty moving the eyes, and is able to tolerate normal light levels. |
| 5 | There is a mild functional impact on activities involving visual function.<br>(1) The person can perform most day-to-day activities involving vision and has mild difficulties seeing things at a distance or close up and at least one of the following applies:<br>(a) the person has mild difficulty seeing the fine print in newspapers or magazines (such as having to hold the print further away or use brighter light);<br>(b) the person has mild difficulty seeing road signs, street signs or bus numbers or has mild difficulty reading road signs at night but can still travel around the community and use public transport without assistance;<br>(c) when looking straight ahead, the person has mild difficulty seeing objects to the side or in the centre of their field of vision;<br>(d) the person experiences mild discomfort when performing day‑to-day activities involving the eyes, such as mild occasional watering of the eyes, mild difficulty opening the eyes, or mild difficulty moving or coordinating the eyes, or mild difficulty tolerating bright lights and sunlight, or mild discomfort when using a computer screen;<br>(e) the person has functional vision in only one eye, or only has one eye, but has good vision in the remaining eye. |
| 10 | There is a moderate functional impact on activities involving visual function.<br>(1) The person:<br>(a) has moderate difficulties seeing things at a distance or close up or the person has very limited vision to the sides when looking straight ahead or the person has other significant loss in their field of vision, such as patches where they can see nothing or very little; and<br>(b) has moderate difficulty performing some day-to-day activities involving vision, such as seeing the print letters, signs or route numbers on approaching buses or at train stations; and<br>(c) has at least one of the following:<br>(i) moderate difficulty seeing routine workplace, educational or training information, such as signs, safety information, or manuals, and may need to use alternative formats, such as large print, assistive devices or technology for vision in work, training or educational settings;<br>(ii) moderate discomfort when performing day-to-day activities involving the eyes, such as frequent watering of the eyes, frequent difficulty opening the eyes, or moderate difficulty moving or coordinating the eyes, or moderate difficulty tolerating normal levels of light indoors or outdoors, or moderate discomfort when using a computer screen;<br>(iii) only one eye or functional vision in only one eye and has mild problems with the vision in their only functioning eye; and<br>(2) The person:<br>(a) is able to function independently in familiar environments without regular assistance; and<br>(b) is able to travel independently using public transport when using any assistive devices that they have and usually use. |
| 20 | There is a severe functional impact on activities involving visual function.<br>(1) The person:<br>(a) has severe difficulties seeing things at a distance or close up; and<br>(b) has severe difficulty performing many day-to-day activities involving vision, such as severe difficulty distinguishing between different types of food in tins or packets, seeing the level of fluid in a cup or reading aisle signs in the supermarket even when standing close to these; and<br>(c) either:<br>(i) has severe difficulty seeing routine workplace, educational or training information, such as signs, safety information, or manuals, even when using any assistive devices or technology that they have; or<br>(ii) needs assistance to use public or other means of transport to travel to work, educational or community facilities; and<br>(d) has severe difficulty moving around independently in unfamiliar environments without assistance. |
| 30 | There is an extreme functional impact on activities involving visual function.<br>(1) The person is not considered permanently blind and, due to extreme functional impact on vision, the person:<br>(a) needs assistance to move around even in familiar environments; and<br>(b) needs assistance to perform most day-to-day activities. |
Table 13 – Continence Function
| Introduction to Table 13 |
| Table 13 is to be used to assess the functional impact of a diagnosed condition related to incontinence of the bladder or bowel.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist, particularly in cases of moderate or severe incontinence, (such as urogynaecologist, gynaecologist, urologist or gastroenterologist) confirming diagnosis of conditions associated with incontinence (such as some gynaecological conditions, prostate enlargement or malignancy, gastrointestinal conditions or malignancy, incontinence resulting from paraplegia, spina bifida, or neurodegenerative conditions);assessments and reports from practitioners specialising in the treatment and management of incontinence (such as urologists, urogynaecologists, continence nurse or continence physiotherapists).<br>When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.Assistance means assistance from a person rather than any aids or equipment a person may use, unless specified otherwise.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no or minimal functional impact on maintaining continence of the bladder and bowel.<br>(1) The person:<br>(a) is always continent of the bladder and bowel; and<br>(b) does not have a stoma, such as colostomy, ileostomy, or use a catheter or other collection device to manage continence. |
| 5 | There is a mild functional impact on maintaining continence of the bladder or bowel.<br>(1) At least one of the following ((a), (b), (c), (d), (e) or (f)) applies:<br>Bladder<br>(a) the person has minor leakage from the bladder, such as a small amount of urine when coughing or sneezing, at least once a day but not every hour;<br>(b) the person has urgency, such as having to get to a toilet very quickly and has difficulty ‘holding on’ to urine, or has occasional (at least weekly) loss of control of the bladder;<br>(c) the person has difficulty passing urine, such as having to strain or has restricted flow of urine or has difficulty emptying the bladder;<br>Bowel<br>(d) the person has minor leakage from the bowel, such as enough faecal matter to soil underwear but not outer clothes, more than once a week but not every day;<br>(e) the person has urgency or occasional (at least monthly) loss of control of bowel;<br>Continence aids<br>(f) the person has a stoma, or uses a catheter or other collection device to manage their continence independently without any difficulties and does not need any assistance. |
| 10 | There is a moderate functional impact on maintaining continence of the bladder or bowel.<br>(1) At least one of the following ((2), (3) or (4)), applies.<br>Bladder<br>(2) The person:<br>(a) has minor leakage from the bladder, such as a small amount of urine when coughing or sneezing several times each day; and<br>(b) in respect of continence of the bladder has difficulties that result in interruption to tasks, work or training on most days.<br>Bowel<br>(3) The person:<br>(a) has major leakage from the bowel, such as enough faecal matter to fully soil underwear and stain outer clothes if a continence pad is not worn, in most weeks; and<br>(b) in respect of continence of the bowel has difficulties that result in interruption to tasks, work or training on most days.<br>Continence aids<br>(4) The person:<br>(a) has a stoma, or uses a catheter or other collection device to manage their continence independently but requires frequent bag or catheter changes, or has frequent equipment failure; and<br>(b) in respect of continence aids has difficulties that result in interruption to tasks, work or training on most days. |
| 20 | There is a severe functional impact on maintaining continence of the bladder or bowel.<br>(1) At least one of the following, ((2), (3) or (4)), applies.<br>Bladder<br>(2) In respect of continence of the bladder:<br>(a) the person has severe difficulty travelling to or participating in community or social environments due to the management of the continence of the bladder, causing frequent disruption to daily activities due to avoidance of activities; or<br>Example: the person avoids using lifts, public transport or being near others due to the nature of their condition.<br>(b) the person has continual dribbling of urine throughout the day that results in interruption to tasks, work or training on most days; or<br>(c) the person has major leakage from the bladder, such as a large amount of urine – enough to soak through a prescribed continence pad and clothes at least every day but not every hour.<br>Bowel<br>(3) In respect of continence of the bowel:<br>(a) the person has severe difficulty travelling to or participating in community or social environments due to the management of the continence of the bowel, causing frequent disruption to daily activities due to avoidance of activities; or<br>Example: the person avoids using lifts, public transport or being near others due to the nature of their condition.<br>(b) the person has minor leakage from the bowel, such as enough faecal matter to soil underwear or continence pad but not outer clothes, every day; or<br>(c) the person has major leakage from the bowel, such as enough faecal matter to fully soil underwear or a continence pad, at least weekly.<br>Continence aids<br>(4) In respect of continence aids:<br>(a) the person has severe difficulty travelling to or participating in community or social environments due to the management of continence aids, causing frequent disruption to daily activities due to avoidance of activities; or<br>Example: the person avoids using lifts, public transport or being near others due to the nature of their condition.<br>(b) the person has a stoma, or uses a catheter or other collection device to manage their continence and needs assistance to manage the continence aid; or<br>(c) the person wears continence pads and needs assistance to change these during the day. |
| 30 | There is an extreme functional impact. The person is completely unable to maintain continence of the bladder or bowel.<br>(1) The person has extreme difficulty travelling to or being in social environments due to symptoms or management of the condition, causing extreme disruption to daily activities and rarely engages in activities outside of the home, and at least (2), (3) or (4) applies.<br>Bladder<br>(2) In respect of continence of the bladder the person has no control of bladder emptying and is always incontinent of urine.<br>Bowel<br>(3) In respect of continence of the bowel the person has no control of bowel emptying and is always incontinent of faeces.<br>Continence aids<br>(4) The person is unable to independently manage any aspects of continence aids. |
Table 14 – Functions of the Skin
| Introduction to Table 14 |
| Table 14 is to be used to assess the functional impact of a diagnosed condition related to disorders of, or injury to, the skin.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist (such as dermatologist, burns specialist or oncologist) confirming diagnosis of dermatological conditions burns, or cancer (such as melanoma, graft versus host disease);assessments or reports from practitioners specialising in the treatment and management of these conditions (such as dermatologists, burn specialists, registered nurses, physiotherapists, pain management specialists or occupational therapists).<br>When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions (such as chronic pain), a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.Assistance means assistance from another person rather than any aids or equipment the person may use, unless specified otherwise.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no or minimal functional impact on activities involving functions of the skin.<br>(1) The person is able to perform normal daily activities (such as washing dishes, shampooing hair, household cleaning and participating in outdoor activities) with no or minimal difficulty. |
| 5 | There is a mild functional impact on activities involving functions of the skin.<br>(1) Regarding the minor adaptations to some daily activities that the person has to make, at least one of the following applies:<br>(a) the person has mild difficulties performing activities involving use of their hands due to minor skin lesions, dermatitis, skin allergies, scarring, skin ulcerations or chronic pain, such as mild allodynia, and may need to wear protective gloves for some tasks, apply protective cream to the hands, or limit repetitive tasks involving use of the hands;<br>(b) the person has mild difficulties performing activities involving use of other parts of the body due to minor skin lesions, dermatitis, skin allergies, scarring, skin ulcerations or chronic pain, such as mild allodynia, and may need to apply protective cream to the body, or limit repetitive tasks;<br>(c) the person has mild difficulties performing activities involving exposure to sunlight due to heightened sensitivity to sunlight, such as impacts of certain medications or past history of skin cancers, and needs to take higher than normal precautions to limit exposure to sunlight. |
| 10 | There is a moderate functional impact on activities involving functions of the skin.<br>(1) Regarding the adaptations to several daily activities that the person has to make, at least one of the following applies:<br>(a) the person has moderate difficulties performing activities involving use of their hands due to skin lesions, dermatitis, skin allergies, scarring, skin ulcerations or chronic pain, such as moderate allodynia, and needs to wear protective gloves for most tasks, avoid contact with all detergents and soaps, or avoid repetitive tasks involving use of the hands;<br>(b) the person has moderate difficulties performing daily activities due to scarring from burns which restricts movement of limbs or other parts of the body, such as they may require additional time to perform some tasks, or some tasks may need to be modified;<br>(c) the person has moderate difficulties performing daily activities due to lesions on skin which require creams or dressings and limit movement and comfort, such as they may require additional time to perform some tasks, or some tasks may need to be modified;<br>(d) the person has moderate difficulties performing activities involving exposure to sunlight due to heightened sensitivity to sunlight, such as the impacts of certain medications, past history of skin cancers, albinism, or other genetic condition, and needs to take higher than normal precautions to avoid exposure to sunlight, such as having to wear sunscreen at all times, wear hat and other protective clothing at all times outside and has to limit time spent outside in sunlight. |
| 20 | There is a severe functional impact on activities involving functions of the skin.<br>(1) Regarding the person’s significant modifications to, or inability to perform, daily activities, at least 2 of the following apply:<br>(a) the person has severe difficulties performing activities involving use of their hands due to major skin lesions, dermatitis, skin allergies, scarring, skin ulcerations or chronic pain, such as severe allodynia, and has severe difficulty performing some tasks involving use of the hands;<br>(b) the person has severe difficulties performing daily activities due to scarring from burns which restricts movement of limbs or other parts of the body, such as they may not be able to perform some tasks, requires additional time to perform some tasks, or some tasks need to be modified;<br>(c) the person has severe difficulties performing daily activities due to extensive or severe lesions on skin which require creams or dressings and limit movement and comfort, such as they may not be able to perform some tasks, requires additional time to perform some tasks, or some tasks need to be modified;<br>(d) the person has severe difficulties performing activities involving exposure to sunlight due to heightened sensitivity to sunlight, such as the impact of certain medications, past history of skin cancers, albinism, or other genetic condition, and can spend only a brief period of time in sunlight each day even when wearing sunscreen and protective clothing;<br>(e) the person is not able to wear clothing or footwear likely to be required in their workplace, including items of personal protective equipment, such as protective glasses, ear defenders, safety jacket, gloves, safety boots, safe shoes or hard hat. |
| 30 | There is an extreme functional impact on activities involving functions of the skin.<br>(1) The person has to make major modifications to most daily activities or is unable to perform most daily activities, requires repeated assistance throughout the day and could not attend a work, education or training session for a continuous period of at least 3 hours as at least one of the following applies:<br>(a) the person has such extensive damage or scarring of their skin that they are unable to perform most daily activities without extreme difficulty or discomfort;<br>(b) the person requires continual application or wearing of medically prescribed creams or dressings to most or all of the skin on the body;<br>(c) the person has extreme reactions to normal exposure to sunlight or skin contact with routine substances found in most households, requiring repeated urgent medical treatment and frequent hospitalisation. |
Table 15 – Functions of Consciousness
| Introduction to Table 15 |
| Table 15 is to be used to assess the functional impact of a diagnosed condition due to involuntary loss of consciousness or altered state of consciousness, such as epilepsy, some forms of migraine, transient ischaemic attacks, or brain tumours.The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner.There must be corroborating evidence of the person’s impairment.Self-report of symptoms must be supported by corroborating medical evidence.Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following:<br>a report from the person’s treating doctor;a report from a medical specialist (such as neurologist, endocrinologist or physician) confirming diagnosis of conditions associated with episodes of loss of or altered state of consciousness (such as epilepsy, transient ischaemic attacks, some forms of migraine, brain tumours, narcolepsy, or cardiac or other forms of syncope);assessments or reports from practitioners specialising in the treatment and management of these conditions (such as neurologists, endocrinologists, or registered nurses).<br>When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity when they would be expected to do so and not only once or rarely.When assessing episodic or fluctuating impairments and conditions, a rating must be assigned which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.The examples used in descriptors are not an exhaustive list and are to be used only as a guide. |
| 0 | There is no functional impact from loss of consciousness or altered state of consciousness.<br>(1) The person does not experience loss of consciousness or an altered state of consciousness when occupied with a task or activity. |
| 5 | There is a mild functional impact from loss of consciousness or altered state of consciousness.<br>(1) The person:<br>(a) has infrequent episodes of involuntary loss of consciousness or episodes of altered state of consciousness, which:<br>(i) occur no more than twice per year; and<br>(ii) do not usually require hospitalisation; and<br>(b) is able to perform most of their usual activities of daily living between episodes; and<br>(c) may have restrictions on a driver’s licence due to the medical condition. |
| 10 | There is a moderate functional impact from loss of consciousness or altered state of consciousness.<br>(1) The person:<br>(a) either:<br>(i) has episodes of involuntary loss of consciousness:<br>(A) which occur more than twice each year but not every month; and<br>(B) which may require the person to receive first aid measures and occasionally emergency medication or hospitalisation; or<br>(ii) has episodes of involuntary altered state of consciousness:<br>(A) which occur at least once per month; and<br>(B) during which the person’s functional abilities are affected, such as they remain standing or sitting but is unaware of their surroundings or actions during the episode; and<br>(b) is able to perform many of their usual activities of daily living between episodes; and<br>(c) is unlikely to be granted a driver’s licence and may have other safety-related restrictions on activities; and<br>(d) is not able to attend work, education or training activities on a fulltime basis and is restricted due to safety issues in the work‑related activities that they can undertake. |
| 20 | There is a severe functional impact from loss of consciousness or altered state of consciousness.<br>(1) The person:<br>(a) either:<br>(i) has episodes of involuntary loss of consciousness:<br>(A) which occur at least once each month; and<br>(B) which may require the person to receive first aid measures and may require emergency medication or hospitalisation; or<br>(ii) has episodes of altered state of consciousness:<br>(A) which occur at least once per week; and<br>(B) during which the person’s functional abilities are affected during these episodes, such as they remain standing or sitting but is unaware of their surroundings or actions during the episode; and<br>(b) has severe difficulty performing many of their usual activities of daily living between episodes; and<br>(c) cannot obtain a driver’s licence or has significant restrictions on medical grounds and has other safety-related restrictions on activities; and<br>(d) has severe difficulty attending work, education or training activities, for at least 15 hours per week. |
| 30 | There is an extreme functional impact from loss of consciousness or altered state of consciousness.<br>(1) The person:<br>(a) either:<br>(i) has frequent episodes of involuntary loss of consciousness:<br>(A) which occur at least once each week; and<br>(B) which may require the person to receive first aid measures emergency medication or hospitalisation; or<br>(ii) has frequent episodes of altered state of consciousness:<br>(A) which occur most days; and<br>(B) during which the person’s functional abilities are affected during these episodes, such as they remain standing or sitting but is unaware of their surroundings or actions during the episode; and<br>(b) is unable to perform most of their usual activities of daily living between episodes; and<br>(c) cannot obtain a driver’s licence on medical grounds and has other safety-related restrictions on activities; and<br>(d) is not able to attend work, education or training activities at all. |
Schedule 1—Repeals
Social Security (Tables for the Assessment of Work‑related Impairment for Disability Support Pension) Determination 2011