GARP Chapter 3: Backs, Knees and Shoulders, Explained Simply

Chapter 3 is the one most veterans need. Backs, necks, shoulders, knees, hips, ankles, wrists.

It is also the chapter with the most rules that catch people out. Here they are in plain words.

Rule 1: both legs are treated as one thing

This is the big one.

You do not get a score for your left knee and another for your right knee. Both legs are rated together as a single unit, and you get one number.

That one number is the higher of:

your worst single joint, or
your walking score

Arms are different. Each arm can be scored on its own.

Rule 2: walking is scored by distance

The walking table works off how far you get before you have to stop. Roughly:

no limit — nil
trouble on stairs and uneven ground — small score
about 500 m — more
about 250 m, or cannot do stairs without a rail — more again
about 100 m, or the leg gives way and you fall
about 50 m, limited to home and the block
only inside the house, with a stick or frame
wheelchair only

So work out your real distance before your appointment. Walk it. Do not guess.

One catch: the walking table is not age adjusted. The joint tables are.

Rule 3: age can lift your joint score

Younger veterans get a bump on joint ratings, because they have longer to live with the problem. A rating of 10 at 40 is worth more than a rating of 10 at 70.

It happens automatically. You do not need to ask for it. But it is worth knowing why two mates with the same knee get different numbers.

Rule 4: the spine is measured two ways

Your neck and your lower back are rated separately from each other. Each one is scored on the higher of:

Movement — how much range you have lost. This needs measuring.
Tolerance of use — how long you can sit or stand before it starts.

Most veterans have never had their range measured. That is fine. The tolerance question is one you can answer yourself:

no trouble — nil
only with long periods of sitting or standing — small
builds up by the end of the day — more
within about 30 minutes, always shifting position — more again
within about 5 minutes — highest

Time yourself at home. Sitting in the car. Standing at the sink. Write it down.

Rule 5: pain at rest is a separate score

This is the one people miss.

If your joints still hurt after you stop using them, that is an extra score on top of everything else. Not instead of.

It goes up depending on whether the pain:

is there at rest but mild
settles after a few hours or with medication
is severe and does not settle with medication
is severe, constant, and wakes you at night

Sleep matters here. If pain wakes you, say it plainly.

You only get one rest-pain score across all your joints, and sciatic pain does not count here — that belongs to the walking table.

Rule 6: arms are scored joint by joint, then as a whole

For each arm, the assessor scores the shoulder, elbow, wrist and hand. Then there is a separate table for the arm as a whole — what you can still do with it. You get whichever is higher.

Grip, reaching overhead, doing up buttons, holding a cup, carrying a bag. Those are the sorts of things that decide it.

What this means for you

Measure your walk. Actual metres before you stop.
Time your sitting and standing. Minutes, not "a while".
Say if pain wakes you. It is worth real points.
Do not describe your best day. Describe a normal week.
List every joint, even the ones you have stopped complaining about.
Ask about Chapter 15 if you get flare-ups that put you out of action for days.

Common questions

Both my knees are shot. Why only one score?

Because the Guide treats the legs as one working unit. It is not an error. The way to get the number up is the walking table, not a second knee.

I have never had my back movement measured. Does that hurt me?

No. The tolerance table is an equal alternative, and for most veterans it gives the higher number anyway.

Does surgery change my rating?

Only through what you are left with. A good result lowers the score. A poor result raises it. The operation itself is not the rating.

What about pain that only comes on with activity?

That is already inside the movement and tolerance tables. The extra pain score is only for pain that carries on after you stop.

You can try all of this yourself on our free PI points calculator.

Next in this series

Chapter 4: mental health.

Want a hand with yours?

If you have a permanent impairment assessment coming up, we do these every week. Call 0429 146 039 or email reception@vhc.org.au.