Medical Disability 

Medical disability is a numerical expression in percent of medical limitations resulting from an illness or various diseases.

How is medical disability determined?

The percentage of disability is determined by medical committees using guides such as Comcare, and may refer to other guides such as Guide to the Assessment of the Degree of Permanent Impairment Edition 2.1,  American Medical Association’s Guides to the Evaluation of Permanent Impairment 5th edition 2001. 

A medical examiner will undertake a review to calculate the level of medical impairment based on standards established by medical guidelines relating to ordinary body function. 

Most claims we deal with relate to your ability to work, and those impairments are expressed in the context of job capacity.

Centrelink has a list of manifest conditions and General Medical Rules

For the purposes of Disability Support Pension, Job Seeker Payment and determining partial capacity to work, medical evidence is corroborating evidence that provides information about a person's medical condition/s  and resulting impact. This documentation may include, but is not limited to:

  1. - Reports, medical records or certificates from medical practitioners including specialists
  2. - Reports from health professionals including allied health professionals
  3. results of diagnostic tests
  4. compensation or rehabilitation reports
  5. medical imaging or operative reports, or
  6. hospital records.

What the general medical rules for Centrelink

The general medical rules are:

General Medical Rules for Insurance Claims

Must have a profound impact on the ability to perform a job suited by education, training or experience (and sometimes any other job depending on your policy's definition); or unable to perform 2 of the 5 Activities of Daily Living.

Trauma/ crisis insurance type policies have defined benefits payable on a diagnosis of a medical condition, such as stroke. Sometimes a benefit percentage is payable based on the severity of the episode.

In conclusion

Determination of medical disability is based mainly on medical documents and professional opinions that reflect the medical condition of the patient and, if necessary, also on a physical examination performed by the medical practitioner or assessor.