Impairment benefits
Policy
The TAC will pay impairment benefits to a client assessed as having a degree of permanent impairment of 11% or more.
Transport Accident Act 1986 reference: s.46A, s.47 and s.48
Further information related to this policy:
Issues Affecting Impairment Benefits
Joint Medical Examinations policy
Accidents before 1 September 2003
Accidents between 1 September 2003 and 15 December 2004
Accidents on and after 16 December 2004
Multiple Accidents before 16 December 2004
Multiple Accidents before and after 16 December 2004
Clients with a 28 Percent or a 29 Percent Impairment
Clients with a 48 Percent or a 49 Percent Impairment
Clients Turning 18 Years of Age
Minors entitlement
Guidelines
What is an impairment benefit?
An impairment benefit is a payment made to a client to compensate him/her for permanent impairment which results from transport accident injuries.
What impairment benefits are available?
The type of impairment benefit and the amount of the impairment benefit a client can receive is set out in the Transport Accident Act 1986 (the Act) and is dependent on the date of the accident.
Depending on the date of the accident, a client may be eligible for the following payments:
- A lump sum impairment benefit and weekly annuity benefits (applies to accidents before 16 December 2004). Refer to the Impairment Payments for Accidents Prior to 16 December 2004 scale
- A lump sum impairment benefit (applies to accidents on or after 16 December 2004). Refer to the Impairment Payments for Accidents on or after 16 December 2004 scale.
How is a client's permanent impairment assessed?
The Act requires the TAC to use the Guides to the Evaluation of Permanent Impairment, second or fourth edition (depending on when the accident occurs) to determine a client's permanent impairment.
The TAC may ask the client to attend an independent impairment examination in order to be assessed. The independent medical assessor submits a medical report to the TAC which provides an opinion as to whether the injuries are stable, substantially stable or not stable. The report also assists the TAC to determine the client's level of permanent impairment. The assessment will be expressed as a percentage impairment of the whole person. On occasion the TAC will use the medical report(s) provided by a client or a client's legal practitioner without needing to obtain an additional independent assessment.
When are injuries considered to be stable, not stable or substantially stable?
- Injuries are considered 'stable', when they are not expected to improve or deteriorate markedly over time with or without treatment. A further assessment of the injuries is not required.
- Injuries are considered 'not stable', when the prognosis is unknown. A further assessment of the injuries is required after further treatment and time has passed.
- Injuries are considered 'substantially stable', when slight improvement or deterioration is expected. A further assessment of the injuries may or may not be required.
Who is eligible for impairment benefits?
- A client with a degree of permanent impairment of 11% or more is entitled to impairment benefits, provided he/she is not convicted of an offence referred to under 'Who is not eligible for impairment benefits?'
- The TAC is only obliged to determine a client's degree of permanent impairment which results from transport accident injuries if a client appears to be or is likely to be entitled to impairment benefits.
- Where it appears that a client is unlikely to have a degree of permanent impairment of 11% or more, the TAC is not required to determine a client's degree of impairment. However, if a client requests to be assessed he/she will be asked to submit up to date medical reports which indicate that he/she is likely to have a permanent impairment of at least 11%.
- Where a client is visiting from overseas and is involved in a transport accident, refer to 'Issues Affecting Impairment Benefits' for further information on entitlement.
Who is not eligible for impairment benefits?
Drivers who are convicted
Impairment benefits are not payable if a driver is:
- convicted of driving or being in charge of a motor vehicle while under the influence of intoxicating liquor or of any drug to such an extent as to be incapable of having proper control of the motor vehicle
- convicted of driving or being in charge of a motor vehicle while the concentration of alcohol present in his or her blood or breath was 0.24 grams or more per 100 millilitres of blood or in the person's breath was 0.24 grams or more per 210 litres of exhaled air, as the case requires
- convicted of refusing to undergo a preliminary breath or blood test or accompany the police officer to a police station
- convicted of refusing or failing to comply with a request or signal to stop a motor vehicle and remain stopped at a preliminary breath testing station
- convicted of refusing to comply with a request to go to a police station, public building, a booze bus, or a police car to furnish a sample of blood or breath
- convicted of hindering or obstructing a doctor from taking a blood sample of any other person involved in the accident
- convicted of culpable driving under the Crimes Act (1958). This is a reference to driving that causes the death of another person by driving a motor vehicle recklessly, negligently or while under the influence of drugs or alcohol, to the extent of being incapable of having proper control of the vehicle.
For all accidents on or after 20 October 2010
Impairment benefits are also not payable if a driver is convicted of:
- dangerous driving causing death, (this is a reference to the driving of a motor vehicle at a speed or in a manner that is dangerous to the public that causes the death of another person). s.319(1) Crimes Act 1958
- driving a motor vehicle or in charge of a motor vehicle while impaired by a drug. s.49(ba) Road Safety Act 1986
- refusing to undergo an assessment of drug impairment in accordance with section 55A of the Road Safety Act when required to do so or refusing to comply with any other requirement made under section 55A(1) of the Road Safety Act 1986. s.49(ca) Road Safety Act 1986
- refusing to comply with a request for a blood and urine sample. s.49(ea) of the Road Safety Act 1986
- refusing to provide a sample of oral fluid. s.49(eb) of the Road Safety Act 1986
For all accidents on or after 1 August 2015
Impairment benefits are also not payable if a driver is convicted of:
- Driving or being in charge of a motor vehicle while both:
- the prescribed concentration of alcohol or more than the prescribed concentration of alcohol is present in the person's blood or breath; and
- the prescribed concentration of drugs or more than the prescribed concentration of drugs is present in the person's blood or oral fluid. s.49(1)(bc) Road Safety Act 1986
- A person has had a sample of blood taken from him or her within 3 hours after driving or being in charge of a vehicle and -
- the prescribed concentration of alcohol or more than the prescribed concentration of alcohol was present in that sample; and
- a prescribed illicit drug was present in that sample in any concentration. s.49(1)(j) Road Safety Act 1986
And the level of concentration of alcohol in the person's blood was 0.24 grams or more per 100 millilitres of blood or in the person's breath was 0.24 grams or more per 210 litres of expelled air, as the case requires.
For all accidents on or after 2 March 2017
Impairment benefits are also not payable if a driver is convicted of:
- an offence in another state or territory, that is equivalent to culpable driving causing death or dangerous driving causing death. Victorian Government Gazette G9 dated 2 March 2017
For all accidents on or after 6 July 2022
Impairment benefits are also not payable to a person convicted of:
- murder, manslaughter or child homicide (section 5A of the Crimes Act) involving the use of a motor vehicle at the time of the accident.
Some of the exclusions involving alcohol or illicit drugs above can be disregarded by the TAC, if it can be proven that the alcohol/drug in no way contributed to the accident. For example, a vehicle is legally parked by the side of the road and is hit by another vehicle. If the driver of the parked vehicle has a blood alcohol reading as above, he/she would not be excluded from receiving impairment benefits.
Excluding the offence of culpable driving under the Crimes Act (1958), a driver convicted of the offences listed above may include a person who is said to be in charge of a motor vehicle by reason of sitting beside a driver who is the holder of a learner permit. An impairment benefit will not be paid in circumstances where a person in charge of a vehicle is convicted of one of these offences.
Drivers with charges pending
- The TAC may withhold a client's impairment benefit payment, where a charge-sheet charging one of the above listed charges has been filed, or if it appears to the TAC that a charge-sheet will be filed within the limitation period.
- The limitation period is the time the police have to file a charge-sheet, or 2 years, whichever is the shorter.
- If a charge-sheet is filed within the limitation period, the TAC will withhold the payment until the charge is heard or withdrawn.
- If a charge-sheet is not filed within the limitation period, the TAC will withhold the payment only until the limitation period expires.
- The TAC may also withhold an impairment benefit payment, even if, a charge-sheet is filed after the client has already attended an impairment exam.
Where the TAC has not made an impairment determination for a client, how long does a client have to request an impairment determination?
For accidents that occurred on or after 19 October 2010
A client or their legal representative can apply to the TAC for an impairment determination within the period of six years from:
- the date of the accident;
- the date on which an injury resulting from a transport accident first manifests itself;
or
- If the client was a minor, six years from the date of the client’s 18th birthday.
Section 46A(1A) of the Transport Accident Act 1986
If the period of six years referred to above has lapsed, and if the TAC within that period:
- has not advised the person that they appear likely to be entitled to an impairment benefit; and
- has not been asked to carry out an impairment assessment
then the TAC is to be taken to have made a determination that the degree of impairment is 0%.
Given the factors that need to be considered, the TAC strongly recommends a client, or their legal representative, contact the TAC before a 0% determination is taken to have been made.
For accidents that occurred on 29 November 2000 up to 18 October 2010
If the TAC has not made an impairment determination, a client has 6 years from the date of the accident or when the injury first manifests to apply to the TAC for a determination. Under the Act, strict time limits apply for a client to lodge a request for impairment benefits, as follows:
- A client who has an existing claim for compensation with the TAC as of 29 November 2000 has 6 years from that date to request an impairment determination.
- A client who has an accident on and after 29 November 2000 has 6 years from the date of the accident or when the injury first manifests, to request an impairment determination.
- A client who was a "minor" on 28/11/2000 has 6 years from the day he/she attains the age of 18 years, to request an impairment determination.
For accidents that occurred prior to 29 November 2000
There was no six year time limit prior to 29 November 2000 in regards to impairment benefits.
For any enquires relating to the 6 year legislation please contact the Impairment Branch at impairment@tac.vic.gov.au or call the TAC on 1300 654 239.
Who is a minor?
Under the Act a person who has not attained the age of 18 years after the date of the accident and is not an "earner" under the Act is considered a "Minor". Refer to the Loss of Earnings Benefits policy for the definition of an "earner" and to the Minors Entitlement policy.
Can the TAC pay for impairment reports that are submitted by a client or a client's legal practitioner more than 2 years after the date of service?
The TAC is unable to pay for the cost of impairment reports submitted by a client or a client's legal practitioner when the "application for payment" is made 2 years after the date that the expense was incurred, except where the request for payment is made within 3 years of the transport accident. In some circumstances the TAC can consider paying for these reports outside this time limit. Refer to the Time Limit to Apply for the Payment of Medical and Like Expenses policy.