Queensland Consolidated Regulations

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CIVIL LIABILITY REGULATION 2014 - SCHEDULE 5

SCHEDULE 5 – Matters relevant to PIRS assessment by medical expert

Part 1 - Explanation of the PIRS

1 PIRS rates permanent impairment caused by mental disorder

The PIRS set out in schedule 6 rates permanent impairment caused by a mental disorder.

Note—
PIRS ratings are referred to in schedule 4 , part 2 . A PIRS rating is capable of being accepted by a court under schedule 3 , section 6 only if it is—
(a) assessed by a medical expert as required under this schedule and schedule 6 ; and
(b) provided to the court in a PIRS report as required under section 12 .

2 Areas of functional impairment

(1) The PIRS consists of 6 scales, each of which rates permanent impairment in an area of function.
(2) Each scale has 5 classes of impairment, ranging from little or no impairment to total impairment.

Part 2 - Assessment of PIRS rating

3 Medical expert must comply with requirements

(1) A medical expert must comply with this schedule and schedule 6 in assessing a PIRS rating for a mental disorder of an injured person.
(2) The medical expert may give an assessment only if the medical expert has examined the injured person.

4 How to assess a PIRS rating

(1) To assess a PIRS rating for a mental disorder of an injured person, a medical expert must follow the steps set out in this section.
Note—
Section 8 provides an example completed worksheet that could be used to assess a PIRS rating.
(2) Step 1—for each area of functional impairment set out in the PIRS, the medical expert must—
(a) decide which level of impairment set out in the PIRS describes the level of impairment caused by the mental disorder of the injured person; and
(b) read off from the PIRS the class (for example, class 1) that corresponds to the level that has been decided.
(3) In deciding which level to choose for an area of functional impairment, the medical expert—
(a) must have regard to—
(i) the examples of indicators of the level of impairment set out in the PIRS for the area to the extent they are relevant in a particular case; and
(ii) all factors the medical expert considers relevant to the injured person’s level of impairment, including, for example, the injured person’s age and pre-existing functional capacity for the area; and
(b) may have regard to the range of percentages of impairment set out in the PIRS for the area as a guide to the level of impairment.
Note—
The examples of impairment set out in the PIRS assume a full pre-existing functional capacity for the area which may not be appropriate in a particular case.
(4) Step 2—the medical expert must list the class number of the 6 classes read off under step 1 in ascending order.
(5) Step 3—the medical expert must work out the median of the class numbers (the
"median class score" ) under section 6 .
(6) Step 4—the medical expert must work out the total of the class numbers (the
"total class score" ) by adding together all of the class numbers.
(7) Step 5—from the conversion table in section 7 , the medical expert must read off the percentage impairment that corresponds to the particular median class score when found in conjunction with the particular total class score.
(8) Subject to section 5 , the percentage impairment is the PIRS rating assessed by the medical expert for the mental disorder of the injured person.

5 Assessment if pre-existing mental disorder

(1) If an injured person has a pre-existing mental disorder, a medical expert must—
(a) work out a percentage impairment for the pre-existing mental disorder at the time immediately before the injury using the steps set out in section 4 (the
"pre-injury rating" ); and
(b) work out a percentage impairment for the current mental disorder using the steps set out in section 4 (the
"post-injury rating" ); and
(c) subtract the pre-injury rating from the post-injury rating.
(2) The remaining percentage impairment is the PIRS rating assessed by the medical expert for the mental disorder of the injured person.
Editor’s note—
See also section 11 (Pre-existing mental disorder).

6 How to work out a median class score

(1) A median class score is the number that would fall at the middle point between the third class number and the fourth class number if all the class numbers are listed in ascending order.
(2) If the median class score under subsection (1) is not a whole number, the median class score must be rounded up to the nearest whole number.

7 Conversion table

This section sets out the conversion table for use under section 4 .

Conversion table for percentage impairment
Median class score
1 2 3 4 5
Total class score 6 0%
7 0%
8 1%
9 1% 4%
10 2% 5%
11 2% 5%
12 2% 6%
13 3% 7% 11%
14 3% 7% 13%
15 8% 15%
16 9% 17%
17 9% 19% 31%
18 10% 22% 34%
19 24% 37%
20 26% 41%
21 28% 44% 61%
22 30% 47% 65%
23 50% 70%
24 54% 74%
25 57% 78%
26 60% 83%
27 87%
28 91%
29 96%
30 100%

8 Example worksheet

This section sets out an example of a completed worksheet that could be used to assess a PIRS rating for a mental disorder.

Area of functional impairment Class
1 Self - care and personal hygiene 1
2 Social and recreational activities 2
3 Travel 3
4 Social functioning 5
5 Concentration, persistence and pace 5
6 Adaptation 5
List of class numbers in ascending order: 1 2 3 5 5 5
Median class score (using section 6 ): 4
Total class score: 21
Percentage impairment (using conversion table in section 7 ): 44%
PIRS rating (if no pre-existing mental disorder): 44%

Part 3 - Particular cases

9 Refusal of treatment

(1) This section applies if an injured person refuses treatment that could lead to a significant improvement in the level of permanent impairment caused by a mental disorder of the injured person.
(2) Despite the injured person’s refusal of treatment, a medical expert may assess a PIRS rating for the mental disorder of the injured person.
(3) The refusal of treatment must not affect the medical expert’s assessment of the PIRS rating.
(4) The medical expert must note the refusal of treatment in the PIRS report and state in the report the likely effect of treatment and any reasons known to the medical expert for the refusal of treatment.
(5) Subsection (6) applies if a PIRS report given to a court states that the injured person refuses treatment that could lead to a significant improvement in the level of permanent impairment caused by the mental disorder of the injured person.
(6) The court may, in assessing the ISV for an injury or multiple injuries of the injured person, take into account the refusal of treatment and the matters stated in the PIRS report under subsection (4) .
(7) In this section—

"PIRS report" means a report under section 12 .

10 Cognitive impairment

If a medical expert assessing a PIRS rating for a mental disorder of an injured person suspects the injured person has a cognitive impairment, the medical expert must take into account the following factors—

(a) the relevant medical history of the injured person;
(b) any medical treatment, and progress towards rehabilitation, for the cognitive impairment;
(c) any results of radiological scans, including CT and MRI scans, electroencephalograms and psychometric tests made available to the medical expert.

11 Pre-existing mental disorder

If a medical expert assessing a PIRS rating for a mental disorder of an injured person considers the injured person had a pre-existing mental disorder, the medical expert must—

(a) make appropriate enquiry into the pre-existing mental disorder; and
(b) consider any psychiatric or psychological reports made available to the medical expert.

Part 4 - Report of PIRS rating

12 Court to be given PIRS report

(1) This section applies if a party to a proceeding wants a court to accept a PIRS rating assessed by a medical expert for a mental disorder of an injured person.
(2) The party must give the court a written report from the medical expert stating the following matters—
(a) the mental disorder diagnosed by the medical expert;
(b) the PIRS rating assessed by the medical expert for the mental disorder of the injured person;
(c) how the PIRS rating is assessed, including—
(i) for each area of functional impairment set out in the PIRS—
(A) the relevant clinical findings; and
(B) the level of impairment set out in the PIRS that the medical expert decided described the level of impairment caused by the mental disorder of the injured person; and
(C) the class set out in the PIRS that corresponds to the level that was decided; and
(ii) the median class score and total class score worked out under section 4 ; and
(iii) if the injured person had a pre-existing mental disorder, the information mentioned in subparagraphs (i) and (ii) in relation to the pre-injury rating and the post-injury rating as defined under section 5 ;
(d) details of any cognitive impairment of the injured person.



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