The Psychiatric Impairment Rating Scale is used to rate impairment arising from psychiatric injuries. It rates function in different areas of daily living, including self-care and personal hygiene, recreational activities, travel, relationships, concentration, persistence & pace, and employability. The PIRS descriptors are based on observable manifestations of psychiatric disorders. This minimizes subjectivity by claimants and assessors. Detailed descriptors improve reliability, and provide a clear explanation for the final rating.
The Psychiatric Impairment Rating Scale (PIRS) was developed in 1999, at the request of the New South Wales Motor Accidents Authority, Australia. Dr Julian Parmegiani chaired the committee that developed the PIRS. The committee was composed of four senior forensic psychiatrists, an occupational physician and a rehabilitation specialist. The PIRS was designed specifically to rate psychiatric impairment in a medicolegal setting. The PIRS proved an effective and reliable instrument, and it was rapidly adopted by the New South Wales Workers Compensation Commission. Other states, including Tasmania, Queensland and Western Australia now use the PIRS to determine the amount of compensation awarded to injured persons. In 2008, the American Medical Association incorporated the PIRS in their Guides for The Evaluation of Permanent Impairment, 6th Edition. The PIRS is now the most widely used instrument, nationally and internationally, in the assessment of psychiatric impairment. It is used to measure impairment arising from work accidents, motor vehicle accidents, medical negligence and other injuries.
The e-PIRS is a web-based questionnaire, based on the PIRS methodology and philosophy. While it is not a substitute for a thorough clinical examination, the result can help a claimant or insurer make a decision about a psychiatric injury claim. For example, many compensation systems exclude small claims by the use of thresholds. When the e-PIRS indicates a low impairment rating, significant additional expenses can be avoided. Conversely, when there is doubt, e-PIRS could help identify significant impairment and provide a basis for further specialist examinations. While the e-PIRS relies on complex algorithms, the results are explained in clear and easily understood terms.
e-PIRS does not determine causality of psychiatric injuries. This is a complex area that requires a thorough assessment of all information, and at times evaluation of conflicting evidence. e-PIRS does not assess whether psychiatric injuries have reached maximum medical improvement (stabilization), or the likely impact of specialist psychiatric treatment.