Blog


Whole person impairment claims

Wednesday, July 01, 2015

WORKERS COMPENSATION  (NSW) WHOLE PERSON IMPAIRMENT CLAIMS

The Workers Compensation Act (NSW) 1987 allows for injured workers to claim a lump sum amount of compensation if they have sustained a permanent impairment as a result of an injury.  This is in addition to payment of weekly compensation and medical expenses.

See our more recent article on WPI claim HERE

To obtain lump sum compensation for permanent impairment you must establish the following:-

  1. Your condition must be stable.  This means that there is unlikely to be any improvement or deterioration in the future.  This usually occurs between six months and one year following the injury.
  2. You need to be assessed by a medico-legal doctor who is approved by the WorkCover Authority of NSW to assess the percentage whole person impairment you have sustained as a result of the injury.
  3. The percentage whole person impairment is determined by the doctor based on his examination with you, medical reports and any x-rays and scans. The doctor must follows the WorkCover Guidelines for the assessment of permanent impairment.  The Guidelines tell the doctor what percentage permanent impairment should be allowed in the circumstances of your injury. 
  4. For example, an injury to the lumbar spine is determined by having regard to categories of impairment. Category I is 0% impairment where there are no signs of injury. Category II is 5-8% whole person impairment where there are some signs of injury but no neurological involvement.  Category III is 10-13% whole person impairment where there are signs of injury and also findings of neurological symptoms on examination.  Category IV is 20-24% whole person impairment where there has been fusion surgery.

The doctor will review your medical records, examine you and then determine the whole person impairment based on the Workcover Guidelines.

You are only entitled to a lump sum amount of compensation if you obtain an assessment of greater than 10% whole person impairment.

You also only have one chance to obtain whole person impairment. You cannot come back later and claim an increase in impairment if your condition gets worse.

If the assessment is 10% whole person impairment or less then you are not entitled to receive an amount for lump sum compensation.

You continue however to be entitled to payments of weekly benefits of compensation and medical expenses.

If the medico-legal doctor has assessed a greater than 10% whole person impairment then your Lawyer will make a claim on your behalf to the insurer asking that they agree to the assessment of whole person impairment.  The insurer will then either agree and pay the amount of compensation allowable under the Act or will dispute the percentage whole person impairment.

The amount payable is determined by a table, for example 11% = $15,400.00, 15% = $22,000.00,

 20% = $30,250.00, 30% = 57,750.00.

If the percentage whole person impairment is disputed then your Lawyer will refer your dispute to the Workers Compensation Commission for resolution and this involves being examined by an independent doctor who provides a final assessment of WPI.

See our more recent article on WPI claim HERE

Should you have any questions in relation to whole person impairment please do not hesitate to contact Matthew on (02) 8518 1120 or info@garlingandco.com.au

About Matthew Garling.

Matthew Garling, Founder of Garling & Co is a NSW Law Society Accredited Specialist in Personal Injury Law. He specialises in compensation law and has acted on behalf of thousands of injured people in work accidents, motor vehicle accidents and negligence cases over the last 20 years.

Comments
Post has no comments.

Post a Comment

Captcha Image