When making a claim for workers compensation, there are a number of considerations that must be taken into account to determine a person’s seriousness of injury and subsequent entitlements available to them. The provisions for these entitlements can be found in the Workers Compensation Act 1987 (NSW).
Under section 66 of the Workers Compensation Act 1987 (NSW) a worker is entitled to lump sum compensation if the workers injury is assessed over a requisite threshold.
If a worker has suffered physical injuries as a result of an accident at work, or due to the nature and conditions of their employment, their physical injuries must be assessed over 10% whole person impairment (“WPI”).
This assessment is undertaken by qualified independent doctor, whose assessment must be in accordance with prescribed guidelines.
If a worker has suffered a primary psychological injury as a result of his or her employment, their psychological injury must be assessed at no less than 15% WPI. A worker is not entitled to receive lump sum compensation for a secondary psychological injury, that is, one that arises from or is attributed to the physical injuries sustained in the subject accident.
Once an agreement or award has been made with respect to the workers WPI, the worker will be entitled to receive lump sum compensation, subject to reaching the necessary threshold.
The amount received for lump sum compensation is dependent on the WPI percentage the worker was assessed at. Each WPI rating attracts a certain sum of compensation prescribed by legislation. This amount is not negotiable between the worker and the insurance company.
Workers assessed over 10% WPI, will also be entitled to receive medical treatment expenses for up to 5 years after receiving their last weekly payment so long as the treatment is considered to be “reasonable and necessary”.
A worker who is assessed over 20% WPI, is considered a worker with high needs. Under the Workers Compensation Scheme in NSW not only does this attract a payment for lump sum compensation, but a worker may also be eligible to receive weekly compensation for periods of incapacity until retirement age, as a result of the injuries sustained in the accident/incident. A worker will be subject to work capacity decisions every 2 years by the insurer to ascertain the worker’s suitability and capacity to perform work. A worker with high needs is also entitled to reasonably necessary treatment expenses for life.
A worker who is assessed over 30% WPI, is considered a seriously injured worker. Seriously injured workers are entitled to a minimum of $736.72 per week in weekly payments, and reasonably necessary medical treatment expenses for life. The need to undergo a work capacity insurer is dispensed with seriously injured workers.
Of note, it is possible to commute Workers Compensation entitlements. This essentially means receiving a lump sum payout from the insurer for the prospective weekly compensation and/or medical treatment expenses, rather than remaining on the Workers Compensation Scheme for whichever applicable period. It is highly recommended that if workers are looking at commuting their entitlements they engage a lawyer so that adequate evidence may be obtained from the necessary health professionals as to the workers anticipated needs and/or capacity in the future.
If you or somebody you know has suffered an injury during the course of employment, you may be entitled to compensation. For more information, and to arrange a free, no-obligation assessment of your claim, please call Stacks Goudkamp on 1800 251 800, or alternatively make an online enquiry.