Recent legislative changes have altered the way in which spinal injuries are to be assessed by medical practitioners. These changes affect people injured in transport accidents but do not have any impact on people who are covered by the WorkCover scheme.
The rationale of the TAC implementing these changes is that they believe that some people who had suffered a relatively minor disability were being compensated at a higher level than other more debilitating injuries. In our experience, this has not been the case. We did not see an increase in impairment for minor injuries. We believe that the TAC were incorrect in this assertion and we note that WorkCover have not adopted the same changes as they did not see a problem with the old impairment guides.
Spinal injuries are assessed in accordance with the American Medical Association’s Guide to the Evaluation of Permanent Impairment in association with the Spinal Impairment Guides.
The Victorian Government Gazette published the Spinal Impairment Guides Modification Document which has allowed changes to the assessment to come into effect. The changes include amendments to the way fractures, spinal surgery and other procedures are assessed.
Prior to the legislative amendments, where there were no fractures of the spine but a spinal fusion had been performed, some doctors were assessing the injury as though there had been a loss of segment integrity, therefore a higher whole person impairment score was obtained.
The fact that a person has undergone surgery or a procedure will no longer in itself be considered as a type of fracture, as it has in the past. The changes stipulate that no impairment score is to be given only for the reason that a person has had surgery, a procedure or shows a sign or symptom of having undergone such surgery or procedure.
The changes have also altered the assessment of multiple fractures. Where there are multiple fractures identified in the one vertebrae, the amendments stipulate that the person cannot be assessed in accordance with the rules relating to conditions affecting multiple vertebrae. If it is the case that there are multiple fractures identified within the one motion segment, these fractures must be assessed individually and an impairment score will be awarded for the highest scoring individual fracture. The fractures cannot be assessed in accordance with the rules relating to multiple fractures.
Where an injured person requires a discectomy, laminectomy or laminotomy, it is to be regarded as at a single level. This applies when the procedures are performed in the same motion segment. For example, different surgical procedures may be required to treat radiculopathy associated with the nerve root between two different levels of the spine but as they are within the same motion segment only a single level procedure will be identified in accordance with the changes.
The practical impact of these changes on people with spinal injuries as a result of motor vehicle accidents is that people who have previously been assessed in a higher category now fall into a lower category. This will decrease the amount of compensation awarded to people who are affected by the legislative amendments.