FOI 24/25-0754 DOCUMENT 11

Impairment categories guide

      SGP KP Publishing

        Exported on 2025-01-20 00:18:10

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FOI 24/25-0754 SGP KP Publishing – Impairment categories guide

Table of Contents

1 Recent updates …………………………………………………………………………………………………….. 4

2 Impairments categories guide ……………………………………………………………………………….. 5

3 Conditions …………………………………………………………………………………………………………….. 6 3.1 Autism (ASD) ………………………………………………………………………………………………………. 6 3.2 Acquired brain injury …………………………………………………………………………………………….. 6 3.3 Intellectual disability ……………………………………………………………………………………………… 6 3.4 Cerebral Palsy ………………………………………………………………………………………………….. 8 3.5 Down Syndrome ………………………………………………………………………………………………….. 8 3.6 Hearing Impairment ……………………………………………………………………………………. 8 3.7 Visual Impairment ………………………………………………………………………………………………… 8 3.8 Other Sensory - Speech ……………………………………………………………………………………. 8 3.9 Multiple Sclerosis …………………………………………………………………………………………………. 8 3.10 Other Neurological ……………………………………………………………………………………. 9 3.11 Stroke ……………………………………………………………………………………………………………… 9 3.12 Other Physical ………………………………………………………………………………………………….. 9 3.13 Psychosocial disability …………………………………………………………………………………….. 10 3.14 Spinal Cord Injury …………………………………………………………………………………………… 10 3.15 Other ………………………………………………………………………………………………….. 11

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FOI 24/25-0754 SGP KP Publishing – Impairment categories guide

This article provides guidance for an access delegate to understand what impairment categories to select for a person that meets the eligibility requirements.

                                                                     Recent updates – 3
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1 Recent updates

14 October 2024 New guidance to:  reflect legislation changes from 3 October 2024  decide what impairment categories to select for a person that meets the eligibility requirements.

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2 Impairments categories guide

Impairments are a loss of or damage to a body’s function. When we assess an impairment to meet access, we look at:  the body’s function  the body’s structure  how they think and learn.

To learn more about impairment categories go to article Descriptions of impairment categories.

The following list provides you with information on:  the condition  the ICD 10 Code  the required impairment category for access assessors to select  optional impairment categories to select as relevant, based on evidence provided with access request.

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3 Conditions

3.1 Autism (ASD)

1.  Autism – includes Rett and Asperger Syndrome
  ICD 10 Codes: F84.0, F84.2, F84.5
   Required impairment category: Neurological
   Optional impairment categories: Intellectual, cognitive, physical, psychosocial

3.2 Acquired brain injury

1.  GlioblastomaICD 10 Code: G71.9
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, physical, psychosocial

2.  Hypoxic brain injuryICD 10 Code: 93.1
   Required impairment category: Neurological
   Optional impairment categories: Physical, psychosocial

3.  Traumatic brain injury – also called head injury and acquired brain damage
  ICD 10 Code: T90
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, physical, psychosocial

3.3 Intellectual disability

1.  Mild intellectual disabilityICD 10 Codes: F70
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive

2.  Moderate intellectual disabilityICD 10 Codes: F71
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, physical, psychosocial

3.  Severe intellectual disabilityICD 10 Codes: F72
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, physical, psychosocial

4.  Profound intellectual disabilityICD 10 Codes: F73
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, physical, psychosocial

5.  Unspecified intellectual disabilityICD 10 Codes: F79
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, sensory, physical, psychosocial

6.  Pervasive developmental disorderICD 10 Codes: F84.8
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, sensory, psychosocial

7.  MicrocephalyICD 10 Codes: Q02
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, neurological, sensory, physical

8.  Other congenital brain conditions – for example, tuberous sclerosis
  ICD 10 Codes: Q04
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, neurological, physical

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9. Spina bifidaICD 10 Codes: Q05 Required impairment category: Physical Optional impairment categories: Intellectual, cognitive, sensory, neurological

10. Foetal alcohol syndromeICD 10 Codes: Q86.0 Required impairment category: Neurological Optional impairment categories: Intellectual, cognitive, sensory, physical, psychosocial

11. Foetal alcohol spectrum disorder (FASD)ICD 10 Codes: Q86.0D Required impairment category: Neurological Optional impairment categories: Intellectual, cognitive, sensory, physical, psychosocial

12. Cornelia de Lange syndromeICD 10 Codes: Q87.1 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

13. Prader Willi syndromeICD 10 Codes: Q87.1 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, physical, psychosocial

14. Coffin-Lowry syndromeICD 10 Codes: Q87.8 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

15. Other congenital conditions (causing intellectual disability)ICD 10 Codes: Q89 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

16. Edwards syndromeICD 10 Codes: Q91 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

17. Patau syndromeICD 10 Codes: Q91 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

18. Cri du Chat syndromeICD 10 Codes: Q93.4 Required impairment category: Intellectual Optional impairment categories: Cognitive, sensory, physical

19. Angelman syndromeICD 10 Codes: Q93.5 Required impairment category: Intellectual Optional impairment categories: Cognitive, sensory, physical

20. Other chromosomal syndromes (including Kabuki & Williams syndromes)ICD 10 Codes: Q99 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

21. Fragile X syndromeICD 10 Codes: Q99.2 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

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3.4 Cerebral Palsy

1.  Cerebral palsyICD 10 Codes: G80
   Required impairment category: Physical
   Optional impairment categories: Intellectual, cognitive, neurological, sensory

3.5 Down Syndrome

1. Down syndromeICD 10 Codes: Q90
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, physical

3.6 Hearing Impairment

1.  Hearing lossICD 10 Codes: H90
   Required impairment category: Sensory
   Optional impairment categories: Cognitive

2.  Congenital hearing conditionICD 10 Codes: Q16.9
   Required impairment category: Sensory
   Optional impairment categories: Cognitive

3.7 Visual Impairment

1.  AlbinismICD 10 Codes: E70.3
   Required impairment category: Sensory
   Optional impairment categories: Not applicable

2.  Visual impairment (including blindness)ICD 10 Codes: H54
   Required impairment category: Sensory
   Optional impairment categories: Not applicable

3.  Congenital eye conditionsICD 10 Codes: Q15.9
   Required impairment category: Sensory
   Optional impairment categories: Not applicable

3.8 Other Sensory - Speech

1.  Other sensory - speechICD 10 Codes: R47
   Required impairment category: Sensory
   Optional impairment categories: Physical

3.9 Multiple Sclerosis

1.  Multiple SclerosisICD 10 Codes: G35
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, physical, psychosocial

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3.10 Other Neurological

1.  Alzheimer's diseaseICD 10 Codes: F00
   Required impairment category: Cognitive
   Optional impairment categories: Neurological, physical, psychosocial

2.  Unspecified dementiaICD 10 Codes: F03
   Required impairment category: Cognitive
   Optional impairment categories: Neurological, physical, psychosocial

3.  Huntington diseaseICD 10 Codes: G10
   Required impairment category: Physical
   Optional impairment categories: Cognitive, neurological, psychosocial

4.  Motor neurone diseaseICD 10 Codes: G12.2
   Required impairment category: Physical
   Optional impairment categories: Cognitive, neurological, sensory, psychosocial

5.  Parkinson's diseaseICD 10 Codes: G20
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, physical, psychosocial

6.  Epilepsy – Mandatory TAPIBICD 10 Codes: G40
   Required impairment category: Neurological
   Optional impairment categories: Intellectual, cognitive, psychosocial

7.  Muscular dystrophyICD 10 Codes: G71.0
   Required impairment category: Physical
   Optional impairment categories: Neurological

8.  Other Neurological – List A and List CICD 10 Codes: G99
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, sensory, physical

3.11 Stroke

1.  StrokeICD 10 Codes: I69
   Required impairment category: Physical
   Optional impairment categories: Cognitive, neurological, sensory, psychosocial

3.12 Other Physical

1.  Rheumatoid arthritisICD 10 Codes: M05
   Required impairment category: Physical
   Optional impairment categories: Not applicable

2.  Other arthritis – mandatory TAPIBICD 10 Codes: M12
   Required impairment category: Physical
   Optional impairment categories: Not applicable

3.  Other physicalICD 10 Codes: M95
   Required impairment category: Physical
   Optional impairment categories: Psychosocial

4.  Multiple traumatic amputationsICD 10 Codes: T05
   Required impairment category: Physical
   Optional impairment categories: Psychosocial

5.  MyopathyICD 10 Codes: G72.9
   Required impairment category: Physical
   Optional impairment categories: Not applicable

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3.13 Psychosocial disability

1.  SchizophreniaICD 10 Codes: F20
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive

2.  Schizoaffective disorderICD 10 Codes: F25.9
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive

3.  Bipolar affective disorderICD 10 Codes: F31
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive

4.  Major depressive illnessICD 10 Codes: F32
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive

5.  Other anxiety disordersICD 10 Codes: F41
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive

6.  Obsessive-compulsive disorderICD 10 Codes: F42
   Required impairment category: Psychosocial
   Optional impairment categories: Not applicable

7.  Post traumatic stress disorderICD 10 Codes: F43
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive

8.  Borderline personality disorderICD 10 Codes: F60.3
   Required impairment category: Psychosocial
   Optional impairment categories: Not applicable

9.  Tourette syndromeICD 10 Codes: F95.2
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, physical, psychosocial

10. Other psychosocial disordersICD 10 Codes: F99
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive

11. AnorexiaICD 10 Codes: R63
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive, physical

3.14 Spinal Cord Injury

1.  Malignant neoplasm of spinal cord complete and incompleteICD 10 Codes: C72.5,
   C72.7
   Required impairment category: Physical
   Optional impairment categories: Neurological, sensory

2.  Spinal cord injury (complete)ICD 10 Codes: T09.5
   Required impairment category: Physical
   Optional impairment categories: Neurological, sensory, psychosocial

3.  Spinal cord injury (incomplete)ICD 10 Codes: T09.7
   Required impairment category: Physical
   Optional impairment categories: Neurological, sensory, psychosocial

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3.15 Other

1.  Malignant neoplasm of brainICD 10 Codes: C71
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, psychosocial

2.  Metastatic cancerICD 10 Codes: C79.9
   Required impairment category: Physical
   Optional impairment categories: Cognitive

3.  Malignant neoplasm of blood or immune diseaseICD 10 Codes: C96
   Required impairment category: Physical
   Optional impairment categories: Cognitive

4.  Autoimmune disordersICD 10 Codes: D89.9
   Required impairment category: Physical
   Optional impairment categories: Cognitive

5.  Obesity – mandatory TAPIBICD 10 Codes: E66
   Required impairment category: Physical
   Optional impairment categories: Psychosocial

6.  Classical phenylketonuriaICD 10 Codes: E70.0
   Required impairment category: Cognitive
   Optional impairment categories: Psychosocial

7.  Disorders of pyruvate metabolism and gluconeogenesisICD 10 Codes: E74.4
   Required impairment category: Intellectual
   Optional impairment categories: Neurological, physical

8.  Other metabolic disordersICD 10 Codes: E88
   Required impairment category: Intellectual
   Optional impairment categories: Neurological, physical

9.  Dementia – rapidly progressingICD 10 Codes: F03.9
   Required impairment category: Cognitive
   Optional impairment categories: Not applicable

10. Functional neurological disorder (FND) – mandatory TAPIBICD 10 Codes: F44.4
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, sensory, physical

11. Other language disorderICD 10 Codes: F80
   Required impairment category: Cognitive
   Optional impairment categories: Not applicable

12. Peripheral neuropathy – does NOT require TAPIBICD 10 Codes: F90.0
   Required impairment category: Neurological
   Optional impairment categories: Sensory, physical

13. Oppositional defiant disorder (ODD)ICD 10 Codes: F91.3
   Required impairment category: Cognitive
   Optional impairment categories: Psychosocial

14. Other hereditary ataxiasICD 10 Codes: G11.8
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, sensory, physical

15. Dementia – early onsetICD 10 Codes: G30.0
   Required impairment category: Cognitive
   Optional impairment categories: Not applicable

16. PlegiaICD 10 Codes: G83.1
   Required impairment category: Physical
   Optional impairment categories: Neurological

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17. Chronic pain – mandatory TAPIBICD 10 Codes: G89.4 Required impairment category: Physical Optional impairment categories: Sensory, psychosocial

18. Postural Orthostatic Tachycardia Syndrome (POTS) – mandatory TAPIBICD 10 Codes: I49.8 Required impairment category: Neurological Optional impairment categories: Physical

19. Lymphoedema – mandatory TAPIBICD 10 Codes: I89.0 Required impairment category: Physical Optional impairment categories: Not applicable

20. Chronic lung diseaseICD 10 Codes: J44.9 Required impairment category: Physical Optional impairment categories:

21. Chronic Obstructive Pulmonary Disease (COPD) – mandatory TAPIBICD 10 Codes: J44.9A Required impairment category: Physical Optional impairment categories: Not applicable

22. Osteoarthritis – mandatory TAPIBICD 10 Codes: M19.9 Required impairment category: Physical Optional impairment categories: Not applicable

23. Systemic lupus erythematosusICD 10 Codes: M32 Required impairment category: Physical Optional impairment categories: Not applicable

24. Ankylosing spondylitisICD 10 Codes: M45 Required impairment category: Physical Optional impairment categories: Not applicable

25. FibromyalgiaICD 10 Codes: M79.7 Required impairment category: Physical Optional impairment categories: Sensory

26. Renal failureICD 10 Codes: N18 Required impairment category: Physical Optional impairment categories:

27. Ehlers Danlos – does NOT require TAPIBICD 10 Codes: Q79.6 Required impairment category: Physical Optional impairment categories: Not applicable

28. DyslexiaICD 10 Codes: R48 Required impairment category: Cognitive Optional impairment categories: Psychosocial

29. Childhood apraxia of speechICD 10 Codes: R48.2 Required impairment category: Neurological Optional impairment categories: Cognitive

30. Short statureICD 10 Codes: R62.5 Required impairment category: Physical Optional impairment categories: Not applicable

31. Amputation – single limb or upper/lower limbICD 10 Codes: Z89 Required impairment category: Physical Optional impairment categories: Cognitive, sensory, psychosocial

32. Amputation – multipleICD 10 Codes: Z89.1 Required impairment category: Physical Optional impairment categories: Cognitive, sensory, psychosocial

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Standard Operating Procedure Document 12

OFFICIAL For Internal Use Only

Add or Change Disability

The content of this document is OFFICIAL. This Standard Operating Procedure (SOP) will help you change the participant’s primary and/or secondary disability in the NDIS Business System (System).

1. Recent updates

What’s changed

July 2021

Clarify actions for non-delegates when requesting to add or change the participant’s disability information in the System.

2. Checklist

Topic	Checklist
Pre-requisites	You have: - checked the participant’s disability information in the System. - information or evidence the participant’s disability information needs to be updated.
Actions	- 3.1 Add or change disability - 3.2 Approve a request to add or change disability

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Standard FOI Operating 24/25-0754 Procedure

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3. Procedure

3.1 Add or change disability

1. From the participant’s NDIS Account select Add Items and select Disability.

2. Select the expander in the Reported Impairment field.

3. Search for and select the participant’s disability.

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• If you are adding a secondary disability go to step 5.

4. Select the check box next to Primary to show the Reported Impairment is the primary disability. Continue to step 6.

   Note: After the access decision is made there can only be one Primary disability.

5. Enter the Effective Start and Effective End dates for any secondary disabilities.

6. At Onset Date enter the date the participant first acquired, developed or experienced their disability (if known).

7. At Evidence of Diagnosis select the type of evidence from the drop down list.

8. Select Submit.

9. A success message displays. The message is different depending on your role in the System. If you are a:

   • Access or Planning delegate – go to 3.1.1 Complete add or change disability
   • Non-delegate – go to 3.1.2 Request to add or change disability

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Standard FOI Operating 24/25-0754 Procedure

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3.1.1 Complete add or change disability (Access and planning delegates)

1. The Disability created successfully message displays. Select OK.

2. Create an interaction using the Interaction Template – General –Primary Disability Change Complete. If you:

   • Made the request make sure the Interaction status is Completed.
   • Did not make the request make sure the Interaction status is Open. Reassign the interaction back to the requestor to notify their request is complete.

   Note: If you are updating a secondary disability, change the details of the interaction to reflect this.

3.1.2 Request to add or change disability (non-delegates)

1. The No authorization to create impairment message displays. Select OK. Your request will be drawn down by an Access or Planning delegate from Work Load Manager (WLM).

2. Create an interaction using the Interaction Template – General –Request to Change Primary Disability. Make sure the Interaction status is Completed.

   Note: In your interaction make sure you include:

   • details of the evidence provided
   • where the evidence is recorded in the System, for example the date and description of the Inbound Document
   • whether your request is for a primary or secondary disability.

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Standard FOI Operating 24/25-0754 Procedure

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3. The approver will assign an Open Interaction using the Primary disability change complete template to you when the request is complete or if you need to take further action.

3.2 Approve a request to add or change disability (access or planning

delegate only)

1. From My Inbox select the Ready for Work.

2. Select Change of Circumstances (CoC) task.

3. Review the information in the Notes Log. Record additional information in the Add Note field, if required.

4. Once you have made a decision, select Mark as Complete.

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5. The Change of Circumstances task completed successfully message displays.

   Select OK.

3.2.1 Approve Request for Disability Update

1. Complete steps in 3.1 Add or change disability.

2. Create an Open Interaction using the Primary disability change complete template.

3. Re-assign the interaction to the requestor advising the disability request is approved and they can start planning tasks.

3.2.2 Decline Request for Disability Update

1. Create an Open Interaction and record the reason you declined the request. Reassign the interaction to the person who made the request.

   Note: If the request is declined due to insufficient information, note what further information or action is required in the interaction.

4. Next steps

1. Make sure the participant’s disability information is updated before you commence planning activities.

5. Related procedures or resources

• Standard Operating Procedure - Create, Assign, Search and Edit an Interaction
• Interaction Templates – General

6. Feedback

If you have any feedback about this Standard Operating Procedure please complete our Feedback Form.

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Standard Operating Procedure OFFICIAL For Internal Use Only

7. Version control

Version	Amended by	Brief Description of Change	Status	Date
1.0	CS0074	Class 1 Approval	APPROVED	2020-02-20
3.0	NAN927	Update guidance on assigning tasks and interactions	Class 1 Approval	APPROVED
4.0	CS0074	Class 1 Approval	APPROVED	2020-05-29
		Updated image of buttons in CRM to show changes from icon to text to describe their purpose.
5.0	JS0082	Class 1 Approval	APPROVED	2020-12-18
		Guidance included to change interaction status to Complete after submitting Change Disability requests in the System.
6.0	JSO0082	Class 1 Approval	APPROVED	2021-07-07
		Restructure to clarify actions for non-delegates

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