Impairment categories guide

FOI 25/26-0524 DOCUMENT 10

Impairment categories guide SGP KP Publishing

Exported on 2025-11-23 23:14:49

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FOI 25/26-0524 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 25/26-0524 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 Page 482 of 528

FOI 25/26-0524 SGP KP Publishing – Impairment categories guide

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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