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Whole person impairment claims

If as a result of injury at work you have sustained a permanent impairment.

The Workers Compensation Act allows for an injured worker to claim a lump sum amount of compensation for that impairment.

If you obtain a lump sum amount for permanent impairment, this does not prevent you from continuing to receive payments of weekly compensation and payments of medical expenses in accordance with the Act.

A threshold of at least 11% whole person impairment must be reached to obtain the lump sum compensation for physical injury and 15% whole person impairment for psychological injury.

What is permanent impairment?

Permanent impairment can be defined as an injury which impairs the physical and/or mental ability of a worker. The degree of permanent impairment that results from an injury is to be assessed by reference to the NSW Compensation Guidelines for Evaluation of Permanent Impairment (1 April 2016).

Permanent impairment is calculated by a medical specialist trained in the use of the guidelines for the evaluation of permanent impairment. Assessing permanent impairment involves the medical assessor undertaking a clinical assessment of the injured worker as they present on the day of assessment. The assessment takes into account the injured workers history and all available relevant medical information to determine:

  • Whether the condition has reached maximum medical improvement (MMI).
  • Whether the injury has resulted in an impairment.
  • Whether that impairment is permanent.
  • Whether that degree of permanent impairment results from the injury.
  • Whether any proportion of that permanent impairment is due to any pre-existing injury, condition, or abnormality.

The medical assessors then follow the guidelines outlined in the Evaluation of Permanent Impairment to obtain a percentage whole person impairment. The percentage of whole person impairment that results from the injury must be determined using the tables, graphs and methodology outlined in the guidelines.

What is whole person impairment?

The method for assessing permanent impairment is for the medical assessor to clinically assess the injured worker and review their history, as well as all relevant medical information to determine a percentage whole person impairment that arises from the injury.

In determining this whole person impairment the medical assessors must use the NSW Workers Compensation Guidelines for the evaluation of permanent impairment.

These guidelines set out in detail tables and methods for evaluating the percentage whole person impairment, the doctor uses these guidelines to make an assessment of the percentage whole person impairment. This includes all of the injuries sustained in the accident.

Physical injuries and psychological injuries cannot be combined to increase the whole person impairment.

The only compensable injury is the primary injury.

For example, if a worker sustains an injury to his low back and then has a secondary psychological injury due to the pain and loss of enjoyment of life as a consequence of the back injury, the only compensable injury is the primary physical injury to the back. The assessor is not allowed to include an assessment of whole person impairment for the psychiatric injury as well as this is a secondary injury.

How do I make a claim for whole person impairment?

You need to consult an expert Accredited Specialist in Personal Injury Law to make a claim for whole person impairment compensation.

The lawyer will arrange for you to be medically examined by a medical specialist who is trained in assessing impairment using the guidelines. Your treating specialist cannot make an assessment as they are usually not trained in the guidelines.

To obtain lump sum compensation for permanent impairment you must be able to establish the following:

  • Your condition must be stable. This means that there is unlikely to be any improvement or deterioration in the future. This usually occurs around 1 year following the injury. This is known as reaching maximum medical improvement (MMI).
  • You need to be assessed by a medico-legal doctor who is approved by WorkCover to assess the percentage whole person impairment.
  • The percentage whole person impairment will be determined by the medical assessor who will rely on the examination with you and all relevant medical reports including any x-rays and scans.
  • The doctor must follow the guidelines for the assessment of permanent impairment. The guidelines tell the doctor what percentage impairment should be allowed in the circumstances of your injury.
  • For example, an injury to the lumbar spine is determined by having regard to categories of impairment. Category 1 is 0%, where there are no signs of injury. Category 2 is 5-8% impairment where there are some signs of injury but no neurological involvement. Category 3 is 10-13% whole person impairment where there are signs of injury and also findings of neurological symptoms on examination. Category 4 is 20-24% whole person impairment where fusion surgery has been undertaken.

Once an assessment of whole person impairment has been obtained, then a claim can be made to the workers’ compensation insurer.

What is the process for obtaining lump sum compensation for impairment?

Once your lawyer has arranged for a medical assessment of whole person impairment then your lawyer will make a claim on your behalf for whole person impairment. They will do this by completing a permanent impairment claim form. The claim form together with the medical report you rely upon is sent to the workers’ compensation insurer.

The insurer then has a period of 2 months in which to investigate the claim. During that 2 month period the insurer may arrange for you to be examined by their own medical assessor to obtain their own assessment of whole person impairment.

Within the 2 month period, the insurer must determine whether they agree and accept the level of whole person impairment as outlined in the permanent impairment claim or whether the claim is disputed.

If the insurance company disputes the level of whole person impairment, then your lawyer is required to make an application to the Workers Compensation Commission to appoint an independent doctor to assess the level of whole person impairment.

After receiving all relevant medical evidence, the Workers Compensation Commission will arrange for you to be examined by an independent medical assessor. The independent medical assessor will examine you, read the relevant medical records, and make an assessment of the percentage whole person impairment in accordance with the guidelines for the evaluation of permanent impairment.

The independent doctors’ assessment of whole person impairment is final and binding on all parties.

The independent doctors’ assessment can be appealed to a medical appeal panel if the assessor has made an error of law.

To obtain lump sum compensation for physical injuries, the assessment of whole person impairment must be 11% or greater

To obtain lump sum compensation for psychological injury, the assessment of whole person impairment must be 15% or greater.

How much lump sum compensation is payable?

The amount of lump sum compensation payable for claims made on or after 19 June 2012 is set out in the table below:

For injuries sustained after 5 August 2015, the amount payable for lump sum compensation has increased as per the table below:

Is the percentage of whole person impairment assessment important for me to continue to receive weekly payments?

Yes. The level of whole person impairment is very important in respect of the following:

  1. How long you are entitled to receive weekly compensation payments.
  2. How long you are entitled to receive medical expenses.
  3. Whether or not you are entitled to pursue a claim in negligence against your employer, known as a Work Injury Damages claim.

Assessment of whole person impairment of 10% or less:

If the assessment of whole person impairment is 10% or less, then the maximum period for which you can receive weekly payments of compensation is 5 years. Medical expenses will also stop 2 years after either the date the claim was made, or 2 years after the last date on which you received weekly payments of compensation, whichever is later.

Assessment of whole person impairment between 11-20%:

If the assessment of whole person impairment is 11-20%, then the maximum period for which you can receive weekly payments of compensation is 5 years. Medical expenses will also stop 5 years after either the date the claim was made, or 2 years after the last date on which you received weekly payments of compensation, whichever is later.

Assessment of whole person impairment of 21% or greater:

If the assessment of whole person impairment is 21% or greater, then you are entitled to receive weekly payments until 12 months after your retirement age subject to the insurer conducting a work capacity decision every 2 years to assess your capacity to work.

Your medical expenses are payable for life.

Assessment of whole person impairment of 31% or more:

If the assessment of whole person impairment is 31% or greater, then you are entitled to receive weekly payments of compensation until 12 months after your Commonwealth statutory retirement age and you are entitled to receive medical expenses for life.

Only one claim for whole person impairment

The Workers Compensation Act allows an injured worker to only make one claim for permanent impairment compensation that results from any injury. After making that one claim you cannot return and claim an increase in lump sum compensation should your condition deteriorate in the future.

The timing of when to make the lump sum claim for whole person impairment is therefore crucial. If you make a claim for whole person impairment too early and the assessment of whole person impairment is for example, less than 10%, you will not receive any lump sum compensation and weekly payments will be limited to a maximum of 5 years and medical expenses for 2 years thereafter.

If say further surgery was required and the whole person impairment was really 25%, then not only would you receive a large lump sum amount of compensation for whole person impairment but you may be able to receive weekly payments until retirement age and medical expenses for life.

The timing and the assessment of whole person impairment is therefore now critical in determining both the amount of lump sum compensation and for how long you are entitled to receive weekly payments and medical expenses.

Does the whole person impairment assessment affect any claim for negligence against my employer?

Yes, the assessment of whole person impairment is also very important if the injury was sustained as a result of the negligence of your employer. You may be entitled to pursue a claim for negligence against your employer, known as a Work Injury Damages claim.

You can only make such a claim if you have a whole person impairment of 15% or greater. Please see our articles on Work Injury Damages.

If you have any question at all, no matter how silly you think it is, please contact me on mgarling@garlingandco.com.au and outline your circumstances and I will personally respond. I receive many emails for help each day and personally respond to all.

You can also call us on (02) 8518 1120 and speak to Matthew Garling.

You can also complete our FREE Confidential Case Assessment Form.

For more information on making a permanent impairment claim in Sydney, please refer to our services page.

Matthew Garling

Matthew Garling is an Accredited Specialist in Personal Injury Law approved by New South Wales Law Society. He is admitted to practice in the Supreme Court of NSW and the High Court of Australia. Matthew is also a member of...
Yanthi S.
01:51 18 May 22
I engaged with Garling and Co to assist me for my weekly payment dispute with the insurance. I was upset with Natasha, as she didn't prepare me to the worse outcome or kind of negotiation in the... hearing. I assumed that as a Lawyer she should experience with the process or the way to solve the case. Even though I asked her what should I do or what would be happened in the hearing a week before but she didn't mentioned anything, and told me not do anything. But in the hearing she and the Arbitrator only gave me less than 5 minute to make decision and pushed me to accept the disappointed outcome and what she said totally different with what she said earlier. I don't trust her at all, her words is not consistent.I would like to express my appreciation to Matthew Garling who had stepped in to handle my weekly payment issue with the insurance. He is very professional, knowledgeable, easy to talk to and very humble. My disappointment earlier has melted away by his kindness and caring to resolve my issue which has came out the great outcome. Now I am satisfied with his expertise therefore I would not hesitate to let him to handle the case I might have in the future.read more
Lynda S
00:34 04 May 22
For such complicated matters, it is extremely important to have a good team in your corner. The right team.Garling and co is just that and much more.They listen to you and care. They support you... during the entire process. You will have so many questions and they always return your calls and reply to your emails.Thank you so much to Renee, who explained everything to me and what to expect in details and really reassured me. The process felt less heavy and stressful because she was there. She was professional and so efficient. She took over my case from previous lawyer and I wish I could have met her first. She was available to answer the many questions I had along the way. There is also Kelli, she was the first person I got on the phone most of the time when I called and she is nice and very helpful, I had so many questions and doubts, I was stressed yet she had the patience to explain and seek answers to my questions.Natasha took over my case towards the end and she also was great in listening and supporting me and made sure to defend my best interests against the other side at all time.The Worker’s compensation process is very stressful, it can last for a long period. In my case it was three years and it is to the upmost importance to have people who treats you well, are professional and efficient.I am very satisfied with the outcome and I hope that this reviews helps the next person.Your assistance made the difference and I would have not been able to do it without your precious help.read more
Melinda B.
23:57 04 Apr 22
Workers compensation and the medical-legal process is a complicated and a difficult process.If you are looking for a highly professional compensation/personal injury lawyer, I would without... hesitation definitely recommend Matthew Garling who is a genuine, caring & dedicated lawyer.Matthew, Allison Luck and co. are extremely professional, clear and concise with all communication and an exceptional support during the whole process of my claim, I felt confident and secure that I had made the right decision having Matthew represent me, they worked tirelessly and where 100% committed to getting me the best possible outcome.My case was complicated and Matthew never gave up fighting for me, he didn’t just take the first option for a quick and easy resolution.He and his team got me the best possible outcome for my WPI and I will be forever grateful for their hard work and diligence. I now have peace of mind knowing I have lifetime medical assistance and payment till retirement age.read more
Jim M.
12:25 27 Mar 22
Garling and Co lawyers you have done again with Success for my TPD claim! Ms. Emma Perkins and her team have assisted my TPD claim with great success after the hard work, She is a very down-to-earth... person, professional, and highly knowledgeable with insurance claim law. She is very approachable and always willing to help and often reply my question of email after business hours. I will most delighted to recommend Garling and Co Lawyers. Ms. Emma Perkins and her team to any person who needs insurance claim law service like me. by Julieread more
Anthony N
22:13 17 Mar 22
I had Garling & Co Lawyers handle my workplace dispute, I could not be happier with the outcome, handled in such a professional way with excellent communication throughout the entire process.Natasha... and Kelli were very understanding in every aspect, requesting information via phone or email was never an issue, fast response times and helpful in every way. I HIGHLY RECOMMEND the team @ Garling & Co Lawyers. 👍read more
Yvonne M.
05:03 21 Jan 22
Zee
14:20 15 Jan 22
I would like to thank the entire team at Garling and Co for being in my corner throughout the worst years I've experienced in my life.I chose Garling and Co in the end after being seriously injured... at work and needing representation, something I should have done years prior.I met with over 12 other legal firms in Sydney. Large,medium, small and all in between. Some were friends, some family, some were sharks, many were pressuring, many promised the world, Matthew was not like that.Matthew was the benchmark as he was one of the first I spoke with and ultimately he stood out in the end as I felt he was the most genuine.From the outset to the conclusion, I found Matthew to be very polite, easy to communicate with and extremely down to earth.He explained everything simply, he had answers for any questions along the way. He told me it how it was, not just what I wanted to hear.Matthew is a genuine nice guy that runs a very efficient and professional law firm. I made the correct choice engaging him in my claims and would not hesitate in recommending him.Renee was also terrific in handling my TPD claim which was literally finalised faster then international postage.Allison, Rebecca and Kelli were all great, always.Thanks again Garling and Co.read more
mark S.
06:30 23 Dec 21
I found from my very first meeting With Matthew that he was upfront honest and to the point . He thoroughly investigated my claim and we agreed too proceed.The staff at Garling and Co are wonderful... and helpful and I was kept informed and upto date from day one till the end .They made me feel confident and secure and I know I had the best team possible for my best outcome .I can’t thank Matthew and the team for their wonderful serviceread more
Daniel F.
08:48 10 Nov 21
My wife suffered psychological injury.Never having similar experience she had to get legal advice.Workers compensation law is complex and she needed someone to help her navigate her way through.... There are many compensation lawyers but not all with enough experience and strong reputation . We have finally decided to go with Matthew and his team based on the independent website reviews .Looking back now we have made the right choice .There is lot of hurdles and having trustworthy lawyer with great communication skills on your side can make huge difference .My wife can now try to move on with the compensation she deserved.Thanks to Matthew ,Allison ,Emma,Rebecca and rest of the team. Thank you again.Daniel and Veerayaread more
K B.
07:35 28 Oct 21
When you work for an employer for a number of decades and suffer a debilitating injury, you expect compassion, support and belief that you are genuine. When you don’t get that and then also have to... deal with Workers Compensation Insurers it slowly breaks you.That's when you need amazing support like Matthew Garling and his team. From my first meeting with Matthew I was confident I was referred to the right guy. I couldn’t be more pleased with my outcome. Matthew is the Guru of workers compensation, he is professional, easy to work with, nothings a bother and most importantly he gets great results. Do not think twice about using Garling and Co Lawyers.Thank you Matthew, Renee, Allison and Kelli for your invaluable support.read more
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Yanthi S.
01:51 18 May 22
I engaged with Garling and Co to assist me for my weekly payment dispute with the insurance. I was upset with Natasha, as she didn't prepare me to the worse outcome or kind of negotiation in the... hearing. I assumed that as a Lawyer she should experience with the process or the way to solve the case. Even though I asked her what should I do or what would be happened in the hearing a week before but she didn't mentioned anything, and told me not do anything. But in the hearing she and the Arbitrator only gave me less than 5 minute to make decision and pushed me to accept the disappointed outcome and what she said totally different with what she said earlier. I don't trust her at all, her words is not consistent.I would like to express my appreciation to Matthew Garling who had stepped in to handle my weekly payment issue with the insurance. He is very professional, knowledgeable, easy to talk to and very humble. My disappointment earlier has melted away by his kindness and caring to resolve my issue which has came out the great outcome. Now I am satisfied with his expertise therefore I would not hesitate to let him to handle the case I might have in the future.read more
Lynda S
00:34 04 May 22
For such complicated matters, it is extremely important to have a good team in your corner. The right team.Garling and co is just that and much more.They listen to you and care. They support you... during the entire process. You will have so many questions and they always return your calls and reply to your emails.Thank you so much to Renee, who explained everything to me and what to expect in details and really reassured me. The process felt less heavy and stressful because she was there. She was professional and so efficient. She took over my case from previous lawyer and I wish I could have met her first. She was available to answer the many questions I had along the way. There is also Kelli, she was the first person I got on the phone most of the time when I called and she is nice and very helpful, I had so many questions and doubts, I was stressed yet she had the patience to explain and seek answers to my questions.Natasha took over my case towards the end and she also was great in listening and supporting me and made sure to defend my best interests against the other side at all time.The Worker’s compensation process is very stressful, it can last for a long period. In my case it was three years and it is to the upmost importance to have people who treats you well, are professional and efficient.I am very satisfied with the outcome and I hope that this reviews helps the next person.Your assistance made the difference and I would have not been able to do it without your precious help.read more
Melinda B.
23:57 04 Apr 22
Workers compensation and the medical-legal process is a complicated and a difficult process.If you are looking for a highly professional compensation/personal injury lawyer, I would without... hesitation definitely recommend Matthew Garling who is a genuine, caring & dedicated lawyer.Matthew, Allison Luck and co. are extremely professional, clear and concise with all communication and an exceptional support during the whole process of my claim, I felt confident and secure that I had made the right decision having Matthew represent me, they worked tirelessly and where 100% committed to getting me the best possible outcome.My case was complicated and Matthew never gave up fighting for me, he didn’t just take the first option for a quick and easy resolution.He and his team got me the best possible outcome for my WPI and I will be forever grateful for their hard work and diligence. I now have peace of mind knowing I have lifetime medical assistance and payment till retirement age.read more
Jim M.
12:25 27 Mar 22
Garling and Co lawyers you have done again with Success for my TPD claim! Ms. Emma Perkins and her team have assisted my TPD claim with great success after the hard work, She is a very down-to-earth... person, professional, and highly knowledgeable with insurance claim law. She is very approachable and always willing to help and often reply my question of email after business hours. I will most delighted to recommend Garling and Co Lawyers. Ms. Emma Perkins and her team to any person who needs insurance claim law service like me. by Julieread more
Anthony N
22:13 17 Mar 22
I had Garling & Co Lawyers handle my workplace dispute, I could not be happier with the outcome, handled in such a professional way with excellent communication throughout the entire process.Natasha... and Kelli were very understanding in every aspect, requesting information via phone or email was never an issue, fast response times and helpful in every way. I HIGHLY RECOMMEND the team @ Garling & Co Lawyers. 👍read more
Yvonne M.
05:03 21 Jan 22
Zee
14:20 15 Jan 22
I would like to thank the entire team at Garling and Co for being in my corner throughout the worst years I've experienced in my life.I chose Garling and Co in the end after being seriously injured... at work and needing representation, something I should have done years prior.I met with over 12 other legal firms in Sydney. Large,medium, small and all in between. Some were friends, some family, some were sharks, many were pressuring, many promised the world, Matthew was not like that.Matthew was the benchmark as he was one of the first I spoke with and ultimately he stood out in the end as I felt he was the most genuine.From the outset to the conclusion, I found Matthew to be very polite, easy to communicate with and extremely down to earth.He explained everything simply, he had answers for any questions along the way. He told me it how it was, not just what I wanted to hear.Matthew is a genuine nice guy that runs a very efficient and professional law firm. I made the correct choice engaging him in my claims and would not hesitate in recommending him.Renee was also terrific in handling my TPD claim which was literally finalised faster then international postage.Allison, Rebecca and Kelli were all great, always.Thanks again Garling and Co.read more
mark S.
06:30 23 Dec 21
I found from my very first meeting With Matthew that he was upfront honest and to the point . He thoroughly investigated my claim and we agreed too proceed.The staff at Garling and Co are wonderful... and helpful and I was kept informed and upto date from day one till the end .They made me feel confident and secure and I know I had the best team possible for my best outcome .I can’t thank Matthew and the team for their wonderful serviceread more
Daniel F.
08:48 10 Nov 21
My wife suffered psychological injury.Never having similar experience she had to get legal advice.Workers compensation law is complex and she needed someone to help her navigate her way through.... There are many compensation lawyers but not all with enough experience and strong reputation . We have finally decided to go with Matthew and his team based on the independent website reviews .Looking back now we have made the right choice .There is lot of hurdles and having trustworthy lawyer with great communication skills on your side can make huge difference .My wife can now try to move on with the compensation she deserved.Thanks to Matthew ,Allison ,Emma,Rebecca and rest of the team. Thank you again.Daniel and Veerayaread more
K B.
07:35 28 Oct 21
When you work for an employer for a number of decades and suffer a debilitating injury, you expect compassion, support and belief that you are genuine. When you don’t get that and then also have to... deal with Workers Compensation Insurers it slowly breaks you.That's when you need amazing support like Matthew Garling and his team. From my first meeting with Matthew I was confident I was referred to the right guy. I couldn’t be more pleased with my outcome. Matthew is the Guru of workers compensation, he is professional, easy to work with, nothings a bother and most importantly he gets great results. Do not think twice about using Garling and Co Lawyers.Thank you Matthew, Renee, Allison and Kelli for your invaluable support.read more
University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
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