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Permanent Impairment

If you are injured during your employment and your injuries are permanent, you may be entitled to make a lump sum permanent impairment claim.

A lump sum permanent impairment claim is separate to your weekly payments claim. If you are successful in your claim for lump sum compensation you will still be able to receive weekly payments of compensation and medical expenses.

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What is Whole Person Impairment?

Permanent impairment refers to an injury which has stabilised and has resulted in ongoing impairment that is unlikely to change within the next 12 months.

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) as a whole person impairment percentage (WPI).

These guidelines set out in detail tables and methods for evaluating the percentage whole person impairment. The doctor uses these guidelines to assess the percentage whole person impairment. This includes all 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 because 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.

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:

Benefits payable for claims made on or after 19 June 2012 – (without regard to any amendment made by the Workers Compensation Amendment Act 2015)

Section 66 of the Workers Compensation Act 1987

Maximum amount payable for multiple injuries (see Note 1) $220,000

Maximum amount payable for back impairment (see Note 2) $231,000

Degree of permanant impairment Benefit
0% $0
1% $0
2% $0
3% $0
4% $0
5% $0
6% $0
7% $0
8% $0
9% $0
10% $0
11% $15,400
12% $17,050
13% $18,700
14% $20,350
15% $22,000
16% $23,650
17% $25,300
18% $26,950
Degree of permanant impairment Benefit
19% $28,600
20% $30,250
21% $33,000
22% $35,750
23% $38,500
24% $41,250
25% $44,000
26% $46,750
27% $49,500
28% $52,250
29% $55,000
30% $57,750
31% $60,500
32% $63,250
33% $66,000
34% $68,750
35% $71,500
36% $74,250
37% $77,000
Degree of permanant impairment Benefit
38% $79,750
39% $82,500
40% $85,250
41% $89,100
42% $92,950
43% $96,800
44% $100,650
45% $104,500
46% $108,350
47% $112,200
48% $116,050
49% $119,900
50% $123,750
51% $127,600
52% $131,450
53% $135,300
54% $139,150
55% $143,000
56% $146,850
Degree of permanant impairment Benefit
57% $150,700
58% $154,550
59% $158,400
60% $162,250
61% $166,100
62% $169,950
63% $173,800
64% $177,650
65% $181,500
66% $185,350
67% $189,200
68% $193,050
69% $196,900
70% $200,750
71% $204,600
72% $208,450
73% $212,300
74% $216,150
75% and over $220,000

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

Permanent impairment compensation amounts payable for injuries received on and from 5 August 2015

Section 66 of the Workers Compensation Act 1987

Amounts payable from 5 August 2015 to 30 June 2016

Degree of permanant impairment Benefit
0% $0
1% $0
2% $0
3% $0
4% $0
5% $0
6% $0
7% $0
8% $0
9% $0
10% $0
11% $22,480
12% $25,420
13% $28,360
14% $31,300
15% $34,240
16% $37,180
17% $40,120
18% $43,060
Degree of permanant impairment Benefit
19% $46,000
20% $48,940
21% $51,880
22% $54,820
23% $57,760
24% $60,700
25% $63,640
26% $66,580
27% $69,520
28% $72,460
29% $75,400
30% $78,340
31% $83,040
32% $87,880
33% $92,720
34% $97,560
35% $102,400
36% $107,240
37% $112,080
Degree of permanant impairment Benefit
38% $116,920
39% $121,760
40% $126,600
41% $131,440
42% $136,280
43% $141,120
44% $145,960
45% $150,800
46% $155,640
47% $160,480
48% $165,320
49% $170,160
50% $175,000
51% $242,010
52% $242,010
53% $242,010
54% $242,010
55% $242,010
56% $309,020
Degree of permanant impairment Benefit
57% $309,020
58% $309,020
59% $309,020
60% $309,020
61% $376,030
62% $376,030
63% $376,030
64% $376,030
65% $376,030
66% $443,030
67% $443,030
68% $443,030
69% $443,030
70% $443,030
71% $510,040
72% $510,040
73% $510,040
74% $510,040
75% and over $577,050

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 unless your condition deteriorates 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.

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 affect a claim for negligence against my employer?

Yes, the assessment of whole person impairment is also very important if the injury was sustained because 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 blog articles on Work Injury Damages.

To be entitled to obtain lump sum compensation for permanent impairment you will need to be assessed by a WorkCover approved medico-legal doctor. The doctor will assess your level of whole person impairment using a set of guidelines issued by SIRA (the old WorkCover).

If you need assistance with your permanent impairment claim, please do not hesitate to contact us as follows;

  1. Complete our FREE case assessment form HERE
  2. Email us at info@garlingandco.com.au
  3. Give us a call on (02) 8518 1120

Would you like assistance with your claim?

Complete our free, no obligation confidential case assessment form and we’ll get back to you within 24 hours.

Alternatively, we are available to talk through phone and email. Please contact our experienced workers compensation lawyers to find out how we can help.

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1/ 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;

  • Your lawyer lodges an Application for Dispute resolution with the WCC which includes all evidence to be relied upon.
  • The Insurer or its lawyer must lodge a reply with their evidence within 28 days.
  • 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).
  • You are notified of this appointment approximately 28 days after the reply is lodged.
  • We will notify you of the details of the medical appointment which you must attend.
  • 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.
  • The report will then be sent to your lawyer.
  • Your lawyer will send you a copy of the report and discuss the outcome.
  • 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.
  • Normally the outcome is simply confirmed by the WCC 28 days later.
  • The insurer will then pay the compensation awarded approximately 6 – 8 weeks later which we will send to you.
  • 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.
  • 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.

2/ Do I need more than 10% Whole Person Impairment?

To claim non-economic loss, that is, pain and suffering, you must have a whole person impairment of greater than 10%.

Usually, your lawyer will arrange for you to be assessed for whole person impairment. You will consult a Doctor who is using the guidelines to assess the % WPI.

Your lawyer will then try and reach an agreement with the insurer that you exceed 10% WPI.

If the insurer does not agree, an application will be made to the medical service of the DRS to appoint an independent Doctor to assess the level of WPI. This is a final and binding assessment on both you and the insurer.

The assessment can be appealed if there is an error is the method of assessing the WPI.

3/ What is lump sum compensation for permanent impairment?

An injured worker may obtain a lump sum amount of compensation if they have sustained a permanent impairment as a result of the injury which occurred in the course of employment.

 

A permanent impairment is an injury that has stabilised and has resulted in an impairment that is unlikely to change within the next 12 months.

 

To determine if you are entitled to a lump sum amount of compensation for permanent impairment, you are assessed by an independent medical examiner known as an AMS. The AMS assesses the whole person impairment using guidelines established by SIRA.

You must obtain an assessment of greater than 10% whole person impairment to be eligible to obtain lump-sum compensation for permanent impairment for physical injuries and 15% for psychological injuries.

If you are eligible for lump-sum compensation for permanent impairment, this is payable in addition to any benefits you are entitled to receive for weekly payments and medical expenses.

The whole person impairment assessment is crucial because it will determine how long you are eligible to obtain weekly compensation and medical benefits.

You also need at least 15% WPI to make claim for damages against your employer, know as a Work Injury Damages claim.

4/ How is the whole person impairment calculated?

The whole person impairment assessment is calculated by medical assessors who determine the level of whole-person permanent impairment based on the following:

  • Guidelines as to how permanent impairments are made which are published by the Motor Accidents Authority of NSW
  • Examine your medical records
  • Conduct a physical medical examination

Based on the guidelines, your medical records, and the physical examination, the medical assessor determines the level of whole-person permanent impairment.

Your lawyer will arrange for you to be examined by a Doctor to assess the WPI and a claim made to the insurer to see if they agree. If no agreement is reached, an Application is made to DRS to appoint an independent Doctor to assess the level of WPI.

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