How are permanent impairment claim disputes determined by the Workers Compensation Commission?

If you have been unable to reach agreement with the insurer on the percentage whole person impairment (WPI) your lawyer will make an Application to the Workers Compensation Commission (WCC) to appoint an independent medical specialist to assess the percentage WPI.

The process is as follows;

  1. Your lawyer lodges an Application for Dispute resolution with the WCC which includes all evidence to be relied upon.
  2. The Insurer or its lawyer must lodge a reply with their evidence within 28 days.
  3. The matter is reviewed by the WCC, if the only issue is the percentage WPI the WCC arranges a medical examination for you to attend with an Approved Medical Specialist (AMS).
  4. You are notified of this appointment approximately 28 days after the reply is lodged.
  5. We will notify you of the details of the medical appointment which you must attend.
  6. The AMS, usually within 28 days, after the appointment will write a report to the WCC. The WCC will review the report and ensure there are no errors.
  7. The report will then be sent to your lawyer.
  8. Your lawyer will send you a copy of the report and discuss the outcome.
  9. An AMS assessment is usually final and binding on both parties unless there has been some error by the AMS. Either the insurer or you can Appeal if an error has occurred.
  10. Normally the outcome is simply confirmed by the WCC 28 days later.
  11. The insurer will then pay the compensation awarded approximately 6 - 8 weeks later which we will send to you.
  12. Usually 10% is also deducted from the lump sum and sent to Medicare as a deposit until it has been determined if Medicare is owed any money.
  13. Sometimes the WCC instead of arranging an AMS appointment will list the matter for a telephone conference to discuss any issues raised by the insurer.