For workers injured from 15 October 2013, their injuries will be assessed using the Guide to the Evaluation of Permanent Impairment (GEPI).
For psychiatric injuries, the assessment must be conducted by the General Medical Assessment Tribunal (GMAT ). There is no review process for these assessments.
The DPI assessment will be issued to the worker in the form of a Notice of Assessment (NOA), once all injuries are assessed. Where an assessment has been reviewed then any new DPI assessment replaces the previous assessment.
Where the injury has not been assessed by a Medical Assessment Tribunal (MAT), the worker must respond to the NOA within 20 business days if they do not agree with the DPI assessment and require a fresh assessment.
For physical injuries, if the worker disagrees with the original assessment by a GEPI trained doctor (“doctor”), they can request referral to the MAT or ask the insurer to consider a medical review by a different doctor. The medical review process is a new step in the assessment process. WorkCover is required to decide within 10 business days of receiving the NOA response whether to have the injury re-assessed by a different doctor or refer it to the MAT.
Outlined below is WorkCover's protocol for arranging assessments of DPI and responding to requests for a new assessment.
What is sent to the doctor and/or MAT
WorkCover will send appropriate material from the worker's claim file to the doctor and/or MAT to enable assessment of the DPI. The claim file will include:
- Initial application form or computer generated form if the application was made over the phone
- All medical and rehabilitation reports and records relevant to the injury
- The first medical certificate, latest medical certificate and any other medical certificates where the diagnosis or capacity has changed
- Additional “relevant documents” as required by s499 and 510C to be provided to the Tribunal.
Choosing a GEPI trained doctor
If a worker disagrees with the initial assessment of DPI, they have the option to nominate a doctor to conduct a fresh assessment of DPI.
WorkCover will only agree to refer a worker for an assessment of DPI if the doctor:
- is GEPI trained and
- is from the relevant specialty based on the worker's injuries and
- has availability to conduct the assessment and provide their report within 2 months of the worker making the request and
- agrees to provide their assessment and report in accordance with GEPI and for the fees provided in the Table of Costs.