Workers compensation has been a very topical and contentious area over the past 3 years. Initially, in relation to retrospective loss of entitlements to injured workers, and more recently in relation to amendments made at the end of 2015, to rectify those loss, to an extent. These most recent amendments have caused an injured worker’s entitlements to weekly benefits, medical expenses and lump sum compensation to be directly correlated to their level of whole person impairment (WPI).
An injured worker’s WPI is expressed as a percentage, calculated by an appropriately qualified doctor using the WorkCover Guides to the Evaluation of Permanent Impairment. Those guides adopt in part the American Medical Association 5th Edition Guides to the Evaluation of Permanent Impairment. Interestingly, those guides expressly state that the level of whole person impairment should not be used to determine a person’s need for weekly benefits or medical expenses. It is simply, supposedly, an indication of their inability to perform activities of daily living.
Regardless, an injured worker’s whole person impairment assessment is now a key component to determining their rights and entitlements under the workers compensation legislation. For example, a person who has a whole person impairment of 10% or less will only be entitled to medical expenses for two years after the expiration of their weekly benefits, whereas a person who has a whole person impairment between 11% and 20% is entitled to 5 years, and anyone greater than 20% is able to claim for life.
A worker’s level of whole person impairment will not always be constant, and can be impacted by various events, including surgery, or consequential conditions. A person who undergoes spinal fusion surgery for example can experience an increase in WPI of 10%.
Unfortunately, a major issue at present is section 322A of the Workplace Injury Management and Workers Compensation Act 1998, which prevents an injured worker from undergoing more than one assessment of their degree of whole person impairment.
This means that the timing of the one assessment is crucial.
Before a worker elects to undergo their one assessment, they should consider the following:
- Do I think my condition is deteriorating?
- Will I need surgery in the future?
- Have I explored all treatment options?
- Have I spoken to my doctor about my potential future needs?
- What areas of my body to I believe I injured at work?
The answers to these questions need to be given significant consideration. Once the assessment has occurred there is no turning back, and the failure to maximise level of whole person impairment can result in the inability to claim thousands of dollars of medical expenses, significant reduction in lump sum compensation, and potentially the inability to pursue a negligence claim against your employer.
If you are at all concerned about the timing of a lump sum claim, or you would like an opinion as to whether now is the right time, our workers compensation lawyers can assist you.
As with any endeavour, it is important that you move forward with as much information as you can to be in the best position to maximise your rights and entitlements. If you have been injured in an accident at work, contact our friendly workers compensation lawyers on 1800 25 1800 or make an online enquiry for a free, no obligation assessment of your claim.
Written by Ryan Brown.
Ryan Brown is a Solicitor in Ian Chipchase and Anna Tavianatos’ Practice Group. Ryan primarily deals with workers compensation claims where he has a growing practice in the niche area of representing injured mining industry workers.