3.6.3.07 Case Examples of Table Use for Permanent Conditions

Condition/diagnosis Example of Impairment Table use
Autism spectrum disorder

Autism spectrum disorder is a developmental disorder often characterised by problems with social interaction and communication. The magnitude and severity of the symptoms can vary widely for individuals. A person with this condition would be assessed according to their presenting symptoms. For example:

  • Table 8 - Communication Function can be used if the person has difficulty with speech.
  • Table 7 - Brain Function can be used to assess the functional impact of cognitive, social interaction and behavioural difficulties if the person has higher functioning autism (Aspergers) but does not have a low IQ.
  • Table 9 - Intellectual Function can be used to assess the functional impact of cognitive, social interaction and behavioural difficulties if the person has autism and a low IQ.

It is important not to rate the same functional impairment twice and a person therefore must not be assessed under both Table 7 and Table 9.

Cerebro-vascular accident (stroke)

A person who has suffered a stroke (cerebro-vascular accident) may have functional impairments in a number of areas depending on the part/s of the brain that have been damaged. In such cases, assessors should use all of the relevant Tables. For example:

  • Table 8 - Communication Function can be used if the person has difficulties understanding or producing speech.
  • Table 2 - Upper Limb Function and Table 3 - Lower Limb Function can be used if the person has paralysis.
  • Table 7 - Brain Function can be used if the person has impaired cognitive functions, such as difficulty with visuo-spatial functioning, attention or concentration.
Chronic fatigue

A person with chronic fatigue syndrome (myalgic encephalomyelitis) may experience a range of symptoms including exhaustion, persistent weakness, pain and neurological problems such as confusion. A person with this condition may have functional impairments in a number of areas, depending on their presenting symptoms. In such cases, assessors should use all of the relevant Tables. For example:

  • Table 1 - Functions requiring Physical Exertion and Stamina can be used if the person experiences limitation in exertion.
  • Table 7 - Brain Function can be used if the person presents with confusion, memory difficulties or other neurological symptoms.
  • Table 10 - Digestive and Reproductive Function can be used if the person experiences gastrointestinal symptoms such as nausea, bloating, constipation or diarrhoea.

If assistance is required to determine the functional impairments caused by this condition, assessors should seek clarification and advice from the person's treating doctor and/or the Health Professional Advisory Unit.

Chronic pain

Acute pain is a symptom which may result in short term loss of functional capacity in more than one area of the body but should resolve itself within a few months.

Chronic pain can be a condition and where it has been fully diagnosed, treated and stabilised, the assessor should assess any loss of functional capacity using the Table relevant to the area of function affected. Chronic pain can also be a symptom and when it stems from a permanent condition the functional impact of the pain should be rated using the relevant Table/s to capture the appropriate level of impairment while ensuring the level of impairment is not overstated or double counted. For example:

  • either Table 2 (Upper Limb Function), Table 3 (Lower Limb Function) or Table 4 (Spinal Function) can be used if the pain impacts the person in one of these areas of the body. These Tables can also be used in combination if the pain impacts the person in multiple areas.
  • Table 1 (Functions Requiring Physical Exertion and Stamina) can be used if the chronic pain impacts the person's physical exertion and stamina (i.e. fatigue symptoms) and is not adequately assessed by another Table.
  • Table 7 - Brain Function can be used if the person has chronic pain which impacts their memory, attention or concentration. Table 7 can be used in conjunction with other Tables, as required.
  • Table 10 - Digestive and Reproductive Function can be used if the person has chronic pelvic pain that impairs their ability to concentrate on or sustain tasks or work activities.
  • Table 14 (Functions of the Skin) can be used if the person has chronic pain related to a disorder of, or injury to, the skin.

If it is unclear how chronic pain should be rated to avoid double counting, the claim should be discussed with the Health Professional Advisory Unit.

Dementia

Dementia is rated under Table 7 (Brain Function) and is a progressive condition that causes a person's abilities to deteriorate over time. The progress of dementia varies between individuals. In some cases, a person's abilities will deteriorate rapidly over a few months, while in other cases a person's abilities will deteriorate more slowly over a number of years. The speed at which a person's abilities are deteriorating should be taken into account in assessing the functional impact of their condition.

The abilities of people with dementia may change from day to day, or even within the same day. If the person's condition is stabilised as episodic or fluctuating, the assessor should apply the rating that reflects the overall functional impact of the impairments, taking into account the severity, duration and frequency of the episodes.

In determining the functional impact of fluctuating conditions, assessors should consider their impact on the person's ability to reliably perform work over the next 2 years without excessive leave or work absences. For example:

  • Approximately 2 weeks sick leave in a 26 week period due to episodic or fluctuating dementia is within what is considered reasonable leave.
  • Sick leave of a month or more in a 26 week period due to episodic or fluctuating dementia is considered excessive leave.
Diabetes mellitus

A person with diabetes mellitus that is fully treated but poorly controlled may experience a range of functional impairments. In such cases, assessors should use all of the relevant Tables. For example:

  • Table 3 - Lower Limb Function can be used if the person has peripheral neuropathy and vascular disease that affects their lower limb function.
  • Table 12 - Visual Function can be used if the person's vision is affected.
  • Table 1 - Functions Requiring Physical Exertion and Stamina can be used if the person has cardiovascular disease that impairs their ability to perform and sustain physical activities.
  • Table 15 - Functions of Consciousness can be used if the person has frequent hypoglycaemic episodes.
Epilepsy

A person with epilepsy may experience seizures where they have involuntary loss or altered state of consciousness. This condition is rated under Table 15 (Functions of Consciousness). The Tables have severity and frequency built into the rating descriptors. For example the descriptor for 20 points on Table 15 includes:

  • The person has episodes of involuntary loss of consciousness due to a diagnosed medical condition at least once each month which require first aid measures and may require emergency medication and/or hospitalisation.
  • OR
  • The person has episodes of altered state of consciousness that occur at least once per week during which the person's functional abilities are affected (e.g. the person remains standing or sitting but is unaware of their surroundings or actions during the episode).
Fluctuating mental health conditions

If a person's mental health condition has been stabilised as episodic or fluctuating (as may be the case with conditions such as bipolar affective disorder), the assessor should apply the rating that reflects the overall functional impact of the impairments, taking into account the severity, duration and frequency of the episodes. Refer to dementia case study above for more detail on assessing conditions that have been stabilised as episodic or fluctuating.

People with mental health conditions may not have good self-awareness of their impairment and may not be able to accurately describe its effects. In determining the functional impact of mental health conditions, Table 5 (Mental Health Function) instructs assessors to consider information from a wide range of sources and not to rely solely on a person's presentation on the day of the assessment.

HIV/AIDS

A person living with HIV (PLHIV) may present with a range of co-morbidities and functional impairments, even where their condition is fully diagnosed, treated and stabilised. The magnitude and severity of symptoms and side effects from treatment can vary widely for individuals. In the assessment of a person living with HIV, assessors should apply all of the relevant Tables. For example:

  • Table 1 - Functions Requiring Physical Exertion and Stamina can be used if the person experiences fatigue.
  • Table 10 - Digestive and Reproductive Function can be used if the person experiences diarrhoea.
  • Table 14 - Functions of the Skin can be used if the person has lipodystrophy (loss or accumulation of subcutaneous fat in various body parts due to HIV infection or side effects of medication).
  • Table 2 - Upper Limb Function and/or Table 3 - Lower Limb Function can be used if the person has peripheral neuropathy such as numbness or tingling of fingertips and/or toes.
  • Various Tables may be used if the person has diabetes mellitus (refer to diabetes mellitus case study above).
  • Table 12 - Visual Function can be used if the person has mycobacterium avium complex (MAC) which causes visual impairment or blindness.
  • Table 5 - Mental Health Function can be used if the person has a psychological disorder, such as clinical depression or bipolar disorder.
  • Table 7 - Brain Function can be used if the person has neurological conditions such as HIV dementia, HIV encephalopathy or Alzheimer's disease.
Hypertension

Fully treated hypertension usually does not result in functional impairment. Where hypertension results in no functional impact, a rating of zero under Table 1 should be assigned.

If severe and untreated hypertension has resulted in other fully diagnosed, treated and stabilised secondary conditions, such as damage to the eyes, kidneys or heart, the functional impacts of these conditions should be rated under the relevant Tables (e.g. Table 12 - Visual Function and Table 1 - Functions requiring Physical Exertion and Stamina).

Malignancy (cancer)

The functional impact of permanent malignancy is variable depending on the body parts or systems involved, the nature and effectiveness of treatment, and the extent or stage of the disease. In the assessment of a person with malignancy, assessors should apply all of the relevant Tables.

People who have terminal malignancy, where the average life of a patient with the condition is 24 months or less, are manifestly qualified for DSP.

Migraine

Different types of migraine may or may not result in a loss of consciousness or altered state of consciousness and this guides Table selection.

If the migraines do not result in a loss of consciousness but the person experiences impairment to neurological or cognitive function, then Table 7-Brain Function can be used. For example severe pain may impair the person's ability with regard to attention and concentration or comprehension.

If the person experiences loss of consciousness or altered states of consciousness as a result of the migraines, then Table 15-Functions of Consciousness can be used.

If the person experiences an altered state of consciousness as a result of a migraine, this may mean that awareness of their surroundings or actions is diminished but they may not completely lose consciousness and may remain sitting or standing.

Miscellaneous ear/nose/throat conditions

Functional impairments resulting from ear, nose and throat conditions would be commonly assessed using Table 8 (Communication Function) and Table 11 (Hearing Function). For example:

  • Table 8 - Communication Function can be used if a person's speech production is impaired due to a laryngectomy (removal of larynx or voice box).
  • Table 11 - Hearing & Other Functions of the Ear can be used if a person's hearing is impaired due to otosclerosis (bone overgrowth in the middle ear) or if their balance is affected due to an inner ear (vestibular) disorder such as Meniere's disease.
Morbid obesity

Morbid obesity (class III obesity) in adults is defined as a body mass index (BMI) of equal to or greater than 40 kg/m2. A BMI of greater than or equal to 40 is generally considered to be incompatible with long term good health, however, does not necessarily correlate with significant functional impact. The functional impact of morbid obesity may range from minimal to very significant. In the assessment of a person with morbid obesity, assessors should apply the Tables relevant to the area of function affected. For example:

  • Table 3 - Lower Limb Function can be used if the person has difficulty walking, using stairs, kneeling or squatting.
  • Table 1 - Functions Requiring Physical Exertion and Stamina can be used if the person experiences symptoms (shortness of breath, fatigue, cardiac pain) when performing physical activities.

Where morbid obesity results in no functional impact, a rating of zero under Table 1 should be assigned.

If morbid obesity has resulted in other fully diagnosed, treated and stabilised secondary conditions, for example, osteoarthritis of the knee joints, the functional impacts of these conditions should be rated under the relevant Tables.

However, where 2 or more conditions cause a common or combined impairment, a single rating should be assigned in relation to that impairment under a single Table. It is inappropriate to assign a separate impairment rating for each condition as this would result in the same impairment being assessed more than once.

Multiple sclerosis

A person with multiple sclerosis (MS) may experience a range of symptoms and symptoms from MS can vary between people. In the assessment of a person with MS, assessors should apply all of the relevant Tables. For example:

  • Table 1 - Functions Requiring physical exertion and stamina can be used if the person experiences fatigue.
  • Table 2 - Upper Limb Function and/or Table 3 - Lower Limb Function can be used if the person has loss of muscle coordination that affects their ability to perform activities using their hands and arms (e.g. lifting and manipulating objects) or legs and feet (e.g. walking).
  • Table 13 - Continence Function can be used if the person's ability to control their bladder or bowel is affected.
  • Table 7 - Brain Function can be used if the person experiences memory loss.
  • Table 11 - Hearing and Other Functions of the Ear can be used if the person has loss of hearing.

Act reference: Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011 Part 2 Rule for applying the Impairment Tables, Table 1 - Functions requiring Physical Exertion and Stamina, Table 2 - Upper Limb Function, Table 3 - Lower Limb Function, Table 4 - Spinal Function, Table 5 - Mental Health Function, Table 7 - Brain Function, Table 8 - Communication Function, Table 9 - Intellectual Function, Table 10 - Digestive and Reproductive Function, Table 11 - Hearing and other Functions of the Ear 46, Table 12 - Visual Function,, Table 13 - Continence Function, Table 14 - Functions of the Skin, Table 15 - Functions of Consciousness

Last reviewed: 2 January 2018