3.6.3.130 Guidelines to Table 13 - Continence Function

Summary

Table 13 is used to assess functional impairment related to incontinence of the bladder or bowel.

The diagnosis of the condition must be made by an appropriately qualified medical practitioner. This includes a general practitioner or medical specialists such as a neuro-gynaecologist, gynaecologist, urologist or gastroenterologist.

Table 13 should be used if a person has an ileostomy or colostomy and requires continence or ostomy care.

Determining the level of functional impact

When determining which impairment rating applies to a person the rating that best describes the person's abilities or difficulties must be applied. In applying the descriptors, each descriptor sets out how the points within it are to apply.

The descriptors in Table 13 use the term 'assistance'. Assistance means assistance from another person, rather than any aids or equipment the person has and usually uses (see 3.6.3.05 (E) Use of aids, equipment & assistive technology).

Under the 5-, 10-, 20- and 30-point descriptors in Table 13, the person must have impairment in either bladder or bowel function (or both) or they must use a continence aid. The points within each descriptor are applied differently within each descriptor.

For example, under the 5-point descriptor at least one of the points (a - f) must apply.

Under the 10-point descriptor, either (2), (3) or (4) must apply. Also, both points under either bladder, bowel or continence aids must apply i.e. both (a) and (b).

Determination of the descriptor that best fits the person's impairment level must be based on the available medical evidence including the person's medical history, investigation results and clinical findings. A person's self-reported symptoms must not solely be relied on. It would be inappropriate to apply an impairment rating based solely on a person's self-reported functional history if this level of functional impairment is not consistent with the medical evidence available.

Where the descriptors refer to the person's condition affecting the comfort and attention of co-workers, this can apply even if the person does not work. Consideration should be given to whether the descriptor would be more than likely to apply if the person did work.

If a person has impairment with both bladder and bowel function a single rating must be assigned which best reflects their overall functional impairment.

Some conditions causing impairment commonly assessed using Table 13

These include but are not limited to:

  • some gynaecological conditions,
  • prostate enlargement or malignancy,
  • gastrointestinal conditions,
  • incontinence resulting from paraplegia,
  • spina bifida,
  • neurodegenerative conditions,
  • severe intellectual disability.

Example: A 48 year old woman suffers from bladder incontinence which she developed following the births of her 4 children. She has undergone numerous treatments for this condition which assisted in improving her symptoms, including pelvic floor muscle retraining, behavioural changes and medication, and a letter from her specialist urologist has indicated that this condition is now fully treated and stabilised. She continues to experience symptoms including involuntary loss of continence when coughing, sneezing and engaging in physical activity. She has to wear a continence pad on a regular basis and suffers minor leakage several times a day. She has to stop what she is doing regularly through the day to change her continence pad.

The condition is considered fully diagnosed, treated and stabilised and under Table 13, this woman would receive an impairment rating of 10 points due to the moderate impact this condition has on her ability to function. Under the 10-point descriptor this woman would meet (2)(a) and (b).

Impairments that should not be assessed using Table 13

Conditions that relate to digestive function which do not result in continence difficulties must be rated on Table 10 - Digestive and Reproductive Function.

Act reference: Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011 Table 13 - Continence Function, Table 10 - Digestive and Reproductive Function

Last reviewed: 1 July 2015