Did You Know? - Understanding PIRS: A smarter way to assess mental health claims

ARTICLE
22 October 2026 dot 3 min read

What is the issue?

Mental health conditions can significantly affect an individual’s ability to function in everyday life and employment. However, the severity and functional consequences of psychiatric conditions can vary considerably between individuals and over time.
 
Assessing psychiatric impairment therefore requires consideration of both clinical evidence and the impact of the condition on everyday functioning.
 
TPD CORE incorporates the Psychiatric Impairment Rating Scale (PIRS) to provide a more structured and consistent approach to assessing the severity of psychiatric impairment in mental health-related TPD claims.

Did you know?

PIRS is not an assessment tool developed by AIA. It is an established psychiatric impairment assessment framework used in Australian workers’ compensation and medico-legal settings.
 
PIRS evaluates the functional consequences of psychiatric conditions across six domains:
 
  • Self-care and personal hygiene
  • Social and recreational activities
  • Travel
  • Social functioning
  • Concentration, persistence and pace
  • Employability
Each domain is assessed using defined impairment classes, with the results combined through a prescribed scoring methodology to determine a whole-person impairment percentage.
 
Unlike an assessment based solely on psychiatric diagnosis or reported symptoms, PIRS provides a structured evaluation of the impact of psychiatric illness on everyday functioning.
 
For TPD CORE, a PIRS whole-person impairment threshold of 31% has been adopted as a benchmark for significant psychiatric impairment.
 
This threshold is a product-specific severity criterion and should not be interpreted as a universally recognised clinical boundary between moderate and severe psychiatric illness.
 
Importantly, the PIRS assessment forms part of the overall evaluation of a TPD claim and does not, in isolation, determine eligibility for benefits.

Why this matters

Incorporating an established psychiatric impairment assessment framework into TPD CORE is intended to:
 
  • Promote greater consistency and transparency in assessing psychiatric impairment.
  • Provide clearer severity criteria for mental health-related TPD claims.
  • Support clinically informed assessment of the functional consequences of psychiatric conditions.
  • Help maintain a sustainable balance between meaningful insurance protection and long-term product affordability.

What you can do next

  • Familiarise yourself with PIRS and its role in assessing psychiatric impairment under TPD CORE.
  • Explain to clients that PIRS provides a structured approach to evaluating psychiatric impairment rather than relying on diagnosis alone.
  • Reinforce that TPD eligibility remains subject to all applicable policy terms, conditions and assessment requirements.
TPD CORE incorporates an established psychiatric impairment assessment framework to support greater consistency, transparency and clarity in mental health-related TPD claims assessment, while maintaining a focus on meaningful and sustainable insurance protection.