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Evidence Guide: FNSPIM504 - Manage impairment benefit claims

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

The important thing to remember when gathering evidence is that the more evidence the better - that is, the more evidence you gather to demonstrate your skills, the more confident an assessor can be that you have learned the skills not just at one point in time, but are continuing to apply and develop those skills (as opposed to just learning for the test!). Furthermore, one piece of evidence that you collect will not usualy demonstrate all the required criteria for a unit of competency, whereas multiple overlapping pieces of evidence will usually do the trick!

From the Wiki University

 

FNSPIM504 - Manage impairment benefit claims

What evidence can you provide to prove your understanding of each of the following citeria?

Determine nature of impairment benefit claim and collect required information

  1. Review impairment benefit claim to determine nature of claim and estimate degree of impairment
  2. Determine type and sources of information and guidelines required to make impairment benefit liability decision
  3. Collect information required for decision-making process, including accessing appropriate services and referrals to independent assessors as required
Review impairment benefit claim to determine nature of claim and estimate degree of impairment

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Determine type and sources of information and guidelines required to make impairment benefit liability decision

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Collect information required for decision-making process, including accessing appropriate services and referrals to independent assessors as required

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Determine liability for impairment benefit

  1. Undertake thorough and systematic review of facts, evidence and information relevant to circumstances of impairment claim
  2. Follow organisational procedures to determine liability of claimed injury for impairment benefit
  3. Use appropriate criteria and guidelines for basis of making sound and sustainable liability decision
Undertake thorough and systematic review of facts, evidence and information relevant to circumstances of impairment claim

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Follow organisational procedures to determine liability of claimed injury for impairment benefit

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use appropriate criteria and guidelines for basis of making sound and sustainable liability decision

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Manage impairment benefit claims process

  1. Determine and apply appropriate legislative, regulatory and organisational policy and procedures to manage impairment benefit claims
  2. Identify stakeholders in impairment benefit process and determine strategies to manage stakeholder relationships
  3. Use appropriate IT systems to collect, analyse, store and access required information
  4. Use appropriate criteria to calculate correct entitlement
  5. Use effective and appropriate strategies to communicate impairment decisions to claimant
  6. Pay entitlement and finalise claim according to organisational procedures
Determine and apply appropriate legislative, regulatory and organisational policy and procedures to manage impairment benefit claims

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify stakeholders in impairment benefit process and determine strategies to manage stakeholder relationships

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use appropriate IT systems to collect, analyse, store and access required information

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use appropriate criteria to calculate correct entitlement

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use effective and appropriate strategies to communicate impairment decisions to claimant

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Pay entitlement and finalise claim according to organisational procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Determine nature of impairment benefit claim and collect required information

1.1 Review impairment benefit claim to determine nature of claim and estimate degree of impairment

1.2 Determine type and sources of information and guidelines required to make impairment benefit liability decision

1.3 Collect information required for decision-making process, including accessing appropriate services and referrals to independent assessors as required

2. Determine liability for impairment benefit

2.1 Undertake thorough and systematic review of facts, evidence and information relevant to circumstances of impairment claim

2.2 Follow organisational procedures to determine liability of claimed injury for impairment benefit

2.3 Use appropriate criteria and guidelines for basis of making sound and sustainable liability decision

3. Manage impairment benefit claims process

3.1 Determine and apply appropriate legislative, regulatory and organisational policy and procedures to manage impairment benefit claims

3.2 Identify stakeholders in impairment benefit process and determine strategies to manage stakeholder relationships

3.3 Use appropriate IT systems to collect, analyse, store and access required information

3.4 Use appropriate criteria to calculate correct entitlement

3.5 Use effective and appropriate strategies to communicate impairment decisions to claimant

3.6 Pay entitlement and finalise claim according to organisational procedures

Required Skills and Knowledge

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Determine nature of impairment benefit claim and collect required information

1.1 Review impairment benefit claim to determine nature of claim and estimate degree of impairment

1.2 Determine type and sources of information and guidelines required to make impairment benefit liability decision

1.3 Collect information required for decision-making process, including accessing appropriate services and referrals to independent assessors as required

2. Determine liability for impairment benefit

2.1 Undertake thorough and systematic review of facts, evidence and information relevant to circumstances of impairment claim

2.2 Follow organisational procedures to determine liability of claimed injury for impairment benefit

2.3 Use appropriate criteria and guidelines for basis of making sound and sustainable liability decision

3. Manage impairment benefit claims process

3.1 Determine and apply appropriate legislative, regulatory and organisational policy and procedures to manage impairment benefit claims

3.2 Identify stakeholders in impairment benefit process and determine strategies to manage stakeholder relationships

3.3 Use appropriate IT systems to collect, analyse, store and access required information

3.4 Use appropriate criteria to calculate correct entitlement

3.5 Use effective and appropriate strategies to communicate impairment decisions to claimant

3.6 Pay entitlement and finalise claim according to organisational procedures

Evidence of the ability to:

interpret and comply with legislative, regulatory and organisational requirements and procedures relating to impairment benefit claims

make sound decisions based on the application of appropriate criteria and the analysis of medical and other information to determine the degree of impairment

accurately calculate and pay the appropriate benefit

effectively communicate decisions to key stakeholders.

Note: if a specific volume or frequency is not stated, then evidence must be provided at least once.

To complete the unit requirements safely and effectively, the individual must:

define and describe a permanent impairment and a total loss injury

identify and describe the different types of impairment benefits

explain legislative and regulatory requirements applicable to personal injury insurance impairment claims management, including:

relevant primary federal, state or territory personal injury insurance legislation

other applicable federal, state or territory legislation governing areas such as privacy, records management, and disability and equal opportunity

outline industry protocols and organisational policy and procedures specific to impairment claims

explain the role of impairment assessment guidelines and criteria, including:

Gazetted Guidelines

American Medical Association (AMA) Guides

case law

outline the fundamental principles of application of assessment guides relating to:

spine

upper extremities

lower extremities

psychiatry

nervous system

hearing loss

ear, nose and throat (ENT)

respiratory

scarring and dermatology

describe the key sources of information, medical specialities and referral processes to independent assessors relevant to impairment benefits.