I recently saw an article on ExpertsDirect, a blog I have not seen before. This has been incoporated in the Victorian Supreme Court Rules adopted on 1 June 2016.
As outlined in our November 2016 blog, Sweeping Changes for Federal Court Practice Notes, the Federal Court, in late 2016, issued 26 updated practice notes for use in federal litigation. The previously used Practice Note CM7 Expert Witnesses in Proceedings in the Federal Court of Australia was replaced with the considerably lengthier Expert Evidence Practice Note (GNP-EXPT) which included 2 annexures, the Harmonised Expert Witness Code of Conduct in Annexure A and the Concurrent Expert Evidence Guidelines in Annexure B.
In this blog, we consider the approach taken in the Harmonised Expert Witness Code of Conduct and the adoption of this Code by a number of states.
Content of the Harmonised Code
The Harmonised Expert Witness Code of Conduct covers issues which are commonly covered by the state based expert witness codes of conduct including:
The application of the code;
An expert witnesses’ duties to the court;
Requirements concerning the content of the report;
Protocol for when an expert changes their opinion;
Duty to comply with the court’s directions; and
Expert requirements when participating in expert witness conferences.
Adoption by the states
Currently, 4 states and territories have adopted the Harmonised Expert Witness Code of Conduct: ACT, NSW, Tasmania, and Victoria. As a result, these states
have a uniform approach to expert witness conduct when compared with the approach in the Federal Courts.
Advisory firm KordaMentha have provided the following summary of the approach taken by each state with respect to their expert witness codes of conduct[1]:
The benefits of a uniform approach to expert witness conduct are widespread.
From the perspective of the expert witness, a uniform standard of expert witness obligations
creates a greater level of consistency across jurisdictions, which will in turn reduce
the complexity for experts operating in different jurisdictions.
It will also enable experts to produce reports more efficiently, with less time spent complying with
state-specific rules and more time focusing on the content of the report.
From the perspective of legal counsel and the client, a uniform system of expert witness guidelines
reduces the need for state-specific guidance for expert witnesses,
which should reduce time spent providing guidance to expert witnesses
who give testimony in multiple jurisdictions. Less time spent by legal counsel on any one task translates to lower fees for the client
and as such, a harmonisation of expert witness codes of conduct should lead to lower fees in relation to preparing expert witnesses for trial.
Non-Adopting States
While the expert witness codes of conduct utilised in the 4 states which have not adopted the Harmonised Expert Witness Code of Conduct
are fairly similar to the harmonised code, differences do exist which add to the requirements with which expert witnesses must comply.
For example, the South Australian code of conduct includes a requirement that an expert witness report ‘identify the differences (if any)
in assumptions made and opinions expressed compared to those made and expressed by a prior expert (if any)’. Such a requirement is not present in the harmonised code of conduct.
Conclusion
The harmonisation of expert witness codes of conducts reflects an exciting step forward for both expert witnesses and
legal counsel responsible for ensuring that the witnesses are aware of the requirements to which they must adhere
in the jurisdiction in which they are testifying. A uniform approach across the nation’s jurisdictions increases efficiency and productivity
in the legal industry and is, without a doubt, a positive step forward for expert witnesses and the legal industry.
[1] Ben Mahler, Expert Matters: Only some experts in harmony, KordaMentha,
All state and territory workers compensation schemes provide coverage for employee trips if they are travelling for work purposes, though only some provide coverage for journeys to and from the workplace.
In Tasmania, South Australia, Western Australia and Victoria an employer is generally not liable for an employee if they are injured on their way to or from work. In Victoria, workers who are injured on this journey are able to apply for compensation under a separate transport accident compensation scheme.
In NSW, the situation is a little more complicated. There is no compensation payable on a journey to or from work unless there is a “real and substantial connection between the employment and accident or incident out of which the personal injury arose”.
Basically this means employers will not be liable for when an employee gets injured on the way to work, unless:
The employee was directed to pick-up work mail on the way to work;
The employee was directed to travel to a training course at a location other than their normal place of work;
The employee was travelling directly to meet a client, rather than going to the office first; or
The employee had an accident due to fatigue when travelling home after a double shift.
In the Northern Territory and the ACT, employers generally are liable for trips to and from work. However, when a worker is in their car and still on their own property they cease to be covered by the scheme.
Liability for such journeys also applies in Queensland. There are, however, a number of exemptions. For example, a worker will not receive any workers compensation for injuries if they break road or criminal laws when the accident happened and this contravention led to the accident. Also, if the injury occurs too long before the employees’ work journey (and the employee was driving in the car at the time) or in a substantial geographical deviation from the journey, then an employer will not be liable.
Journey for ‘work purposes’
If a worker injures themselves on an authorised journey for work purposes the employer may be liable. In most states and territories, the relevant legislation is very broad and can include injuries incurred on journeys during lunch breaks or other breaks. Employers may even be liable if a worker injures themselves whilst getting a work certificate or whilst training at an external training provider.
In virtually all states, an employer is not liable for the injury if it is the result of serious and wilful misconduct of the worker.
On 1 December 2016, the Senate referred the following matter to the Senate Community Affairs References Committee for inquiry and report:
The complaints mechanism administered under the Health Practitioner Regulation National Law.
The terms of reference are:
the implementation of the current complaints system under the National Law, including the role of the Australian Health Practitioner Regulation Authority (AHPRA) and the National Boards;
whether the existing regulatory framework, established by the National Law, contains adequate provision for addressing medical complaints;
the roles of AHPRA, the National Boards and professional organisations, such as the various Colleges, in addressing concerns within the medical profession with the complaints process;
the adequacy of the relationships between those bodies responsible for handling complaints;
whether amendments to the National Law, in relation to the complaints handling process, are required; and
other improvements that could assist in a fairer, quicker and more effective medical complaints process.
The focus of this inquiry is the implementation and regulation of the complaints mechanism administered under the Health Practitioners Regulation National Law. Submissions outlining details of individual cases or complaints may assist the committee in identifying broader systemic issues for investigation. However, the committee has no power to investigate, advocate for or resolve individual cases. To protect the privacy of submitters, the committee has resolved not to publish any submissions outlining individual cases
Please note: All correspondence, submissions and other evidence provided to the committee’s previous inquiry into the medical complaints process in Australia is available to the committee for this inquiry. This means that submissions accepted by the committee for its previous inquiry do not need to be re-submitted.
Submissions should be received by 24 February 2017. The reporting date is 10 May 2017.
If you are considering lodging a submission to this inquiry you should consider the guidance on preparing a submission to an inquiry available on the Senate website.
Committee Secretariat contact:
Committee Secretary
Senate Standing Committees on Community Affairs
PO Box 6100
Parliament House
Canberra ACT 2600
A paper published in 2014 concludes that the stresses associated with making a workers compensation claim make recovery less likely.
The authors conclude:
Many claimants experience high levels of stress from
engaging with injury compensation schemes, and this experience is positively
correlated with poor long-term recovery. Intervening early to boost resilience
among those at risk of stressful claims experiences and redesigning compensation
processes to reduce their stressfulness may improve recovery and save money.
Those of us who are a little more cynical may have come to different conclusions
such as the lack of incentive for many people to return to work and being paid
not to work is a powerful driver.
I wonder how many academics actually have much understanding of this complex system.
I may have mentioned before that in one year there was a major outbreak of mental health
in the Victorian police Force as the number of WorkCover claim halved. It was probably
because the superannuation schemes suddenly became much more generous and
more accessible and the number of superannuation claims made more than doubled during that year.
Their findings were that 6% of all workers compensation claims were for mental disorders .
The typical compensation payment for such a claim was $23,600 totalling $480 million for the 7820 Australian claimants. The average period of time spent off work was 14.8 weeks. 39% of these claims were for harassment/bullying/exposure to violence. 90% of all mental disorder claims were attributed to stress.
65% of all mental disorder claims were awarded to workers aged 40 or over.
For 1 million hours of work there were 0.5 mental disorder claims.
Occupations most at risk:
First responders-police, paramedics and firefighters comprising one in five of this group
welfare and community workers affirm one in 10 were compensated, prison officers, bus and rail drivers and teachers of whom one in five were compensated.
The more common conditions included reactions to stressors (41%), anxiety/stress disorders (28%) and post traumatic stress disorder (11%). Combined they accounted for, on average, about 4/5 mental disorder claims over the period.
Their findings were that: Over four years, the number of stress-related claims increased by 25 per cent. In 2015/16, there were 547 stress-related claims lodged, representing
3.2 per cent of all workers’ compensation lost-time claims.
Although the number of stress-related claims increased, the frequency rate (claims per million hours worked) for stress-related claims is stable.
Females accounted for 59 per cent of stress-related claims compared with 41 per cent for males.
In terms of prevalence of stress claims, female workers tend to have a higher frequency rate.
The top three industries for stress-related claims were:
Health care and social assistance 25%
public administration and safety 24%
education and training 16%
The causes of stress and later claims included:
Work pressure 39%
Harassment and bullying 23%
exposure to a traumatic event 19%
exposure to workplace violence 14%
other causes 5%
There appears to be a significant drop in the number of stress-related claims in WA representing 3.2% of all workers compensation lost time claims, the WorkSafe Australia statistics were that 6% of all claims were stress-related. In Victoria in the late 1990s about 5.5% of all claims were stress-related. There appears to have been little real change in the incidence of stress-related disorders over the last 20 years.
Examination and provision of report and certificate — psychiatric — complex assessment (eg. reviewing significant documented prior psychiatric history) $3554.35 or $3863.35 (minus fee for intrpreter. Think about what you get paid.
The Victorian Ombudsman has released a report regarding an “Investigation into the management of complex workers compensation claims and WorkSafe oversight”
This report is very critical of practices of WorkCover agent’s particularly with regard to doctor shopping and is unsparing in its criticism of certain IMEs in particular with regard to their bias and poor quality reports. The report is a damning with regard to actions taken by work safe about IME reports that are inadequate. Based on the reports the following recommendations relevant to psychiatrist were made. A copy of the full report is available in publications and a summary is also available.
Recommendation 14
Implement changes to the current IME system to:
prevent agents from selectively using ‘preferred IMEs’ or
provide injured workers a choice of the IME with the appropriate speciality, by whom they are examined.
Recommendation 15
Amend its IME complaint handling policy to provide scope for examination of complaints where a worker does not provide consent for the complaint to be provided to the IME, which may include the referral of the matters raised to the IME quality assurance division for intelligence gathering purposes.
Recommendation 16
Amend the IME quality assurance process to:
ensure IMEs subject to a high number of complaints are peer reviewed
document the process by which WorkSafe will review an individual claim file where significant deficiencies are identified in relation to an IME’s report, to ensure a worker’s entitlements have not been unreasonably rejected or terminated based on the
I have written a draft submission to the Medical Board of Australia expressing significant concerns about revalidation. The one area I have not included is probably the most important: What is the problem? Where is the evidence this complicated process is required? Is it just more Nanny state bullshit because the profession cannot be trusted?
These are the recommendations of thew Medical Board Expert Advisory Group. They are also present in the revised CPD program of the RANZCP
The recommendations include:
maintaining and enhancing the performance of all doctors practising in Australia through efficient, effective, contemporary, evidence-based continuing professional development (CPD) relevant to their scope of practice (‘ strengthened CPD’), and
proactively identify doctors at-risk of poor performance and those who are already performing poorly, assessing their performance and when appropriate supporting the remediation of their practice.
The Expert Advisory Group (EAG) proposes that medical practitioners in Australia should participate in three core types of CPD, with activities prioritised to strengthen individual performance. A summary is provided of the core types of CPD.
Undertaking educational activities:
lectures
conferences
Reading
research
supervision
workshops
grand rounds
online learning
Reviewing performance:
peer review of performance
peer-review of medical records
peer discussions of cases, critical incidents, safety and quality events
multisource feedback from peers, medical colleagues, co-workers, patients, other health practitioners.
Measuring outcomes
clinical audit
review of medical records
mortality and morbidity reviews
clinical indicators
comparison of individual data with local, institutional, regional datasets
review of individual and comparative data from de-identified large datasets e.g. Medicare, PBS
The problem is that this is a generic list that does not fit some groups. The people who do medicolegal work measuring outcomes is meaningless. All of the third component has no relevance. Reviewing performances is also problematical particularly multisource feedback from peers, medical colleagues, co-workers, patient, other health practitioners. How on earth do we do that.
Similarly peer-reviewed medical records. We have no medical records we have reports. The reports are assessed by the various statutory schemes and by lawyers and ultimately attested in court. There is no recognition of that. Peer review is something that we do anyway but again there are no medical records so how can there be peer review of medical records other than peer review of reports. Most of us read many reports from our colleagues and sometimes give feedback with regard to these. We also have peer discussion of cases but we don’t have to deal with critical incidents.
I urge you to make your views known if you agree with this analysis.
The Transport Accident Amendment Act 2016 was enacted in mid April 2016 (see effect of changes). The Act reverses the provisions enacted in the Transport Accident Amendment Act 2013 that limited the right of families of people who die or are severely injured in transport accidents to seek compensation for psychological injury.
The requirement that claimants with psychiatric injuries needed to seek treatment for three years before they can bring a serious injury claim has also been reversed. It did not recognise that many people suffering from mental illness find it difficult to reach out for assistance. Furthermore, it was especially difficult for claimants living in rural areas who may have limited access to mental health services.
The Victorian ombudsman has taken it upon herself to have an enquiry into the use of Independent medical examiners by WorkCover agents. We have had significant concerns about potential outcomes. In particular one of our members has been targeted by the ombudsman with the possibility of a recommendation that he no longer see WorkCover claimants. In an interesting denial of natural justice he has had no opportunity so far to respond to allegations made by a disgruntled claimant. In general however the focus of the investigation is on the agents rather than on Independent medical examiners. Nevertheless the Victorian Branch of the faculty of forensic psychiatry thought it would be useful to make a submission to the Ombudsman explaining our obligations including the College code of ethics, guidelines for medicolegal examinations, the WorkCover handbook for medicolegal assessment and legal requirements of expert witnesses. You can see a copy of the submission here
This review funded by the ISCRR demonstrates that in many instances, injured workers with long-term complex injuries experience difficulties when receiving health services in the context of workers’ compensation systems. Independent medical examiners were a source of contention for both injured workers and healthcare providers (HCP), and likely exert a negative influence on the therapeutic relationship. Healthcare providers experience problematic interactions with insurers, and injured workers bear the brunt of healthcare providers’ frustration as some HCP’s offer poorer quality service or refuse to treat compensable clients as a result.
Supportive patient-centred interaction with HCP’s who have high job satisfaction is important for injured worker recovery. Reduction of organisational pressures and improving communication between insurers and service providers could result in increased job satisfaction for HCP’s and ensure that providers are more amenable to operating in compensation systems. Improved HCP participation and job satisfaction will more than likely have a corresponding positive influence on injured workers’ recovery and return to work.
At the meeting, this diverse range of stakeholders raised a multitude of views and concerns, particularly the lack of mental health consumer and carer input into private health network.
Adjunct Assoc. Prof. Kim Ryan
CEO, Australian College of Mental Health Nurses
Professor Malcolm Hopwood
President, RANZCP
Professor Lyn Littlefield
Executive Director, Australian Psychological Society
Professor Morton Rawlin
Vice President, Royal Australian College of General Practitioners
Dr Bill Pring
Private Mental Health Alliance (PMHA), AMA Observer
Mr Frank Quinlan
CEO, Mental Health Australia
Ms Georgie Harman
CEO, Beyondblue
Ms Sue Murray
CEO, Suicide Prevention Australia
Ms Marita Cowie
CEO, Australian College of Rural & Remote Medicine
Mr David Meldrum
Executive Director, Mental Illness Fellowship of Australia
Mr David Butt
CEO, National Mental Health Commission
Ms Janet Meagher
Consumer representative
National Mental Health Consumer and Carer Forum
Ms Eileen McDonald
Carer representative
National Mental Health Consumer and Carer Forum
Mr Stephen Brand
Senior Manager, Policy & Advocacy
Australian Association of Social Workers
Professor Tom Calma
Advisor
Australian Government Department of Health
Ms Natasha Cole (Chair)
First Assistant Secretary, Health Services Division
Australian Government Department of Health
Ms Colleen Krestensen
Assistant Secretary, Mental Health Reform Taskforce
Australian Government Department of Health
Dr Anthony Millgate
Assistant Secretary, Mental Health Services Branch
Australian Government Department of Health
Ms Emma Gleeson
Acting Assistant Secretary,
Mental Health Early Intervention Branch
Australian Government Department of Health
AMA Psychiatry Newsletter April 2016; AMA Qld submission to the Office of the Health Ombudsman
The Office of the Health Ombudsman (OHO) was established by the Queensland Government in 2013 to strengthen the health complaints management system. It replaced the Health Quality and Complaints Commission (HQCC), an organisation that had been criticised for fundamental deficiencies in the way it handled complaints, as well as unjustified delays in dealing with complaints against medical practitioners. Plus ca change plus la meme chose!
Highlights:
The absence of medical practitioner leadership and guidance
Suspension of natural justice and procedural fairness in Investigations ; the approach of the OHO is unnecessarily antagonistic
Unreasonably prolonged complaints resolution time (, even where the matter is trivial or vexatious); mandated time frames not followed with no explanation.
Health Ombudsman weakening the national system
The OHO, as it currently operates, creates differing standards and thresholds between itself and the Medical Board of Australia. Thus less consistency of decisions, poor data comparability, reduced confidence of medical practitioners and patients in the decisions of both bodies.
I have written previously about the problems forensic psychiatrists have had with vexatious notifications to the Medical Board. Two of our colleagues had had four notifications each, three of them had been shown to have no merit but it appeared that four notifications required action and so the two psychiatrist had a practice visit from two other psychiatrist over a period of a day. I thought this was questionable with regard to ethical practice in particular the psychiatrist roared through all the medical records not just those to do with the notifications and apparently sat in on one or two interviews.
Complaints were made to the Medical Board of Victoria by our representatives and as you will see there has been dialogue with the AMA. Some information about this was provided in the April newsletter of the Medical Board of Australia. (See below)
Improving the notification process
Continuing our work on a fair and timely process
Senior leaders from the Board, AHPRA and the AMA met in February 2016 to look at ways in which doctors’ experience can be improved when a notification is made about them. This was the second workshop with the AMA about this. The first workshop was held 12 months ago.
There was positive feedback about changes we have made in the last 12 months to improve the experience of doctors involved in the regulatory process. Improvements include:
significantly reduced time frames for assessing matters. This means that low risk notifications can be resolved and high risk notifications can be investigated more quickly
development of a decision matrix with the health complaints entities (HCEs) we work with in each state and territory to better steer complaints and notifications to the most appropriate pathway
improved communication with practitioners. We have reviewed and revised the templates we use as the starting point for our correspondence with doctors and we are now providing more information to practitioners, particularly when we expect our inquiries to take longer than first thought, and
senior staff and Board members are reviewing notifications at specific times, to make sure regulatory work is on track.
The workshop also explored what we are doing to support good regulatory decision-making including:
establishing a Risk-based Regulation Unit in AHPRA, to analyse our data to help identify risk of harm. As this work progresses, we will be publishing the results of our analysis to help inform and educate practitioners
setting up a National Restrictions Library. This is a collection of conditions and other restrictions that decision-makers can use to ensure that any restrictions they impose on practitioners’ registration to manage risks to patients, are consistent, enforceable and able to be monitored, and
asking notifiers what they are looking for from the regulatory process and providing more information up front about what it can achieve. This helps to better align notifier expectations with possible outcomes. As well, AHPRA is usually providing practitioners with all the information provided by the notifier, but specifying within this the issues that the Board is investigating.
The Board and AHPRA agreed to explore how we can most usefully ask practitioners for feedback about their experience of the regulatory process when a notification has been made about them, so we can improve our processes.
There was also good discussion about how the experience of the National Scheme1 can better support the profession to deal with practitioners whose performance is not satisfactory.
The Board and AHPRA appreciate the AMA’s commitment to continuing to work constructively with us to improve the process for practitioners, in a fair way, with clear information.
Western Australia is pressing ahead with its 2013 plan to replace the State Workers’ Compensation and Injury Management Act 1981 with a new statute, WorkCover WA has confirmed.
“The drafting of the Bill is a significant undertaking and is at a preliminary drafting stage with Parliamentary Counsel’s Office,” a spokesperson said yesterday.
The State Government has been quiet on the proposed laws since approving the drafting process in October 2014 .
The spokesperson confirmed that the new statute will be based on recommendations from WorkCover’s June 2014 report on the old Act, and the Government will consult broadly on the Bill before introducing it to Parliament.
“I cannot confirm when it will be introduced to Parliament at this stage,” he said.
WorkCover’s 171 recommendations included: replacing the “complex and highly prescriptive” 1981 Act with a new Act; redefining “worker” as “an ’employee’ for the purpose of assessment for Pay As You Go (PAYG) withholding” under Commonwealth taxation laws; enforcing whole person impairment thresholds for common law claims; and significantly increasing death benefits
The Workplace Injury Rehabilitation and Compensation Act (the WIRC Act) recasts the Accident Compensation Act 1985 ( the ACA Act) and the Accident Compensation (WorkCover Insurance) Act 1983 (ACWI Act) into a single Act that is simpler and easier to use.
This link gives you a table that indicates where the provisions of the Accident Compensation Act 1985 can be found in the Workplace Injury Rehabilitation and Compensation Act 2013 that became operational on 1 July 2014.
Of particular significance is section 91 (6) in the ACA Act that has been replaced with Section 64 (a) and (b) with regard to psychiatric impairment assessment.
There has been action on two fronts with regard to reviewing the current system of medical complaints. The Senate has established a wide ranging review (see below) and AHPRA has provided some insights into a KPMG independent review of that system and processes for managing notifications in Victoria. I reckon I could have written this in my coffee break. It includes such mind-boggling new ideas such as: better risk assessment Management of high-risk matters greater transparency culture performance
You will notice that the item to do with “culture” refers to ” address perceptions of being pro-practitioner”. That has certainly not been our experience. Our experiences that you are guilty until proven innocent.
These are astonishing glimpses of the obvious. Go to the section below to read the full document.
On 2 February 2016, the Senate referred the following matter to the Senate Community Affairs References Committee for inquiry and report:
the prevalence of bullying and harassment in Australia’s medical profession;
any barriers, whether real or perceived, to medical practitioners reporting bullying and harassment;
the roles of the Medical Board of Australia, the Australian Health Practitioners Regulation Agency and other relevant organisations in managing investigations into the professional conduct (including allegations of bullying and harassment), performance or health of a registered medical practitioner or student;
the operation of the Health Practitioners Regulation National Law Act 2009 (the National Law), particularly as it relates to the complaints handling process;
whether the National Registration and Accreditation Scheme, established under the National Law, results in better health outcomes for patients, and supports a world-class standard of medical care in Australia;
the benefits of ‘benchmarking’ complaints about complication rates of particular medical practitioners against complication rates for the same procedure against other similarly qualified and experienced medical practitioners when assessing complaints;
the desirability of requiring complainants to sign a declaration that their complaint is being made in good faith; and
any related matters.
Submissions should be received by 13 May 2016. The reporting date is 23 June 2016.
Committee Secretariat contact:
Committee Secretary
Senate Standing Committees on Community Affairs
PO Box 6100
Parliament House
Canberra ACT 2600
The report recommends actions in five main areas, including a more systematic, data informed approach to risk assessing notifications:
Better risk assessment: need to embed a more systematic, data informed approach to risk assessing notifications not only taking account of the information which is outlined in the notification, but also factors such as a practitioner’s history of notifications, their practice context and who made the notification.
Management of high risk matters: more intensively apply resources to higher-risk notifications, so these cases are investigated thoroughly but quickly.
Greater transparency: interpret and use the National Law flexibly, not narrowly, to support information sharing in the public interest and promote greater understanding and transparency of what we do.
Culture: address perceptions of being pro-practitioner and shift this perception through cultural change, with a greater emphasis on service. We need to drive an open and transparent organisational culture with a clear balance between the interest of patients, public safety and the practitioner to ensure our service culture balances the rights and needs of all stakeholders.
Performance: continue to critically evaluate the causes of delays, especially for high risk and complex cases.
How many people go back to work after a claim? This is a research paper from Work Safe Australia Returned to Work Rate is the proportion of injured workers with 10 or more days off work who returned to work for any period of time at some stage since they had their first day off work.In 2013/14, 87% of Australian injured workers and 88% of New Zealand injured workers had returned to work at some time since their injury or illness.
Within Australia, the Returned to Work Rate was higher than the national Rate for Comcare (92%); and Queensland and Western Australia (89% each). The Returned to Work Rate was lower than the national rate for Tasmania, the Northern Territory (86% each), Victoria (85%) and South Australia (82%)
There have been a number of amendments to the Victorian Wrongs Act 1958 (Wrongs Act Amendment Act) that took effect on 2 December 2015. The major issue for us is with regard to psychiatric assessment. The threshold wording has been changed from “impairment of more than 10%” to “10% or more”. This applies to any climate to have been assessed before that date where the matter has not yet been finalised. Victorian forensic psychiatrists will be asked to submit a new certificate incorporating the changed wording. There are 5 changes in all of which the above is the only one relevant to us.
