4. Assessment

4. Assessment

Gathering information during the assessment phase is usually done via 3 methods:

Interview

Discussions with multiple people to achieve triangulation of data:

  • Client
  • Employer
  • Family
  • Clinicians

Data gathering in this way includes structured interviews, informal discussions and reading of reports. 

Observation

Observation of task performance is a key component of client assessment in brain injury rehabilitation, particularly to test whether clients with high language skills have commensurate task performance (i.e. can people do what they say they can do?). This type of assessment has high ecological validity.

  • Consider assessing known versus unfamiliar tasks, depending on the goal of assessment.
  • Consider: observation of the client or co-worker performing work tasks at the job site, or observation of a client in clinical assessment or simulated task.
  • Job roles containing manual operations are easily observable. Management and professional job roles are less amenable to observation. 

Measurement

To quantify client’s performance a range of aspects of the client and environment can be measured:

Within FCE:

  • Lifting capacity
  • Hand function
  • Balance
  • Work posture tolerance
  • Cognition (test scores)

Within workplace assessment:

  • Cognitive task demands
  • Physical task demands
  • Environment (noise, light etc)
  • Pace of work / productivity Key Performance Indicators

Global measure of functioning (Health of the Nations Acquired Brain Injury Scale (HoNOS-ABI) and other outcome measures)

 

Compensability

Participants of the VIP may have compensation claims if their brain injury was sustained in a motor vehicle accident or accident at work. The insurers/agents responsible for these claims will not be funding VIP services but may fund some associated costs. Therefore such agents require information about the services provided, work status and outcomes achieved, as they are responsible for managing the overall compensation claim.

Workers compensation

Brain injury sustained in an accident at work; or brain injury sustained as a driver/passenger/pedestrian travelling where there is a real and substantial connection to their work duties.  

  • Note that a client injured in MVA may have additional Compulsory Third Party (CTP) and/or Lifetime Care (LTC) claims
  • Note that in NSW, workers are no longer covered under workers compensation in the normal course of travelling to/from work.
  • The Workers compensation scheme agent will continue to manage the claim including making weekly payments, payment of medical and related expenses , as per their entitlements and making decisions regarding a worker’s work capacity. 

Lifetime Care (LTC)

Severe brain injury sustained in an MVA (driver, passenger  or pedestrian) regardless of fault. Criteria of injury severity are applied to determine eligibility for entrance into the LTC scheme.  The LTC funds treatment and care services but does not pay income support to the client, nor lump sum payments.   

Compulsory Third Party (CTP)

Brain injury sustained in a motor vehicle accident where the client was not-at-fault is covered under CTP.  For those with a brain injury who meet the LTC scheme brain injury severity criteria, LTC is responsible for their treatment, rehabilitation and care services. The client may have a claim for other heads of damages such as economic loss and non-economic loss through the CTP insurer.

For those clients whose brain injury does not meet the LTC scheme criteria, the CTP insurer is responsible for managing the overall claim, including treatment, rehabilitation and care services as well as any claim for other heads of damages.