Lump Sum Compensation for Work Injuries

Hoona Li | Solicitor

Workers Compensation Lump Sum Compensation

Lump Sum Compensation is possible if you have injured yourself at work or become sick due to work in New South Wales, you are entitled to lodge a workers compensation claim with the state-based scheme, icare, which is an insurance corporation owned by the New South Wales Government.

Under the workers compensation scheme in NSW, injured workers are generally entitled to three main benefits as follows:

Reasonable medical expenses occurred as a result of a work-related injury or illness, and the associated travelling expenses and rehabilitation.
Loss of income in the form of weekly payments while you are not fit for work.
Lump sum compensation for permanent impairment.

Today, we are looking at lump sum compensation for permanent impairment which is one of the main three statutory benefits under the scheme.

Who is eligible to make a lump sum claim?

If you have suffered permanent impairment as a result of the work-related injury or illness, you may be entitled to receive a lump sum payment as compensation.

Permanent impairment can be defined as permanent damage or loss to any part of the bodily system or function which impairs the physical and/or mental ability of a worker. Some examples of physical injuries that lead to permanent impairment are as follows:

Surgeries, such as spinal surgery and joint replacement
Injuries that affect multiple body parts
Shoulders, elbows or knees with restricted range of movement
Hearing loss caused by work
Nerve damage
Disc bulges

Injuries that cause permanent impairment can also be psychological. For instance, a psychiatric disorder such as PTSD can be considered permanent, if it is determined by a psychiatrist that it is likely to continue indefinitely.

A lump sum claim is essentially designed to compensate you for the overall effect your work injury has had on your life in the form of a lump sum payout. For injuries that occurred on and from 1 January 2002 are based on an assessment of permanent impairment.

If your lump sum claim is made on or after 19 June 2012, you must have at least 11% whole person impairment (WPI) for a physical injury or 15% WPI or more for a primary psychological injury, in order to be entitled to receive a lump sum payout in NSW.

Maximum Medical Improvement & WPI Assessment

The Whole Person Impairment (WPI) is a scale that measures the degree of permanent impairment you have suffered as a result of your injury. The WPI percentage will be determined by an Independent Medical Examiner (IME), also referred to as a medico-legal assessor, who is trained in the evaluation of permanent impairment.

A list of trained assessors of permanent impairment can be found on the SIRA website of https://www.sira.nsw.gov.au/information-search/permanent-impairment-assessors.

However, the WPI assessment for the purpose of pursuing a lump sum claim cannot be done until the workers have reached a level of Maximum Medical Improvement (MMI). MMI is considered to occur when the worker’s condition becomes well stabilised and is unlikely to get any better or worse in the following year with or without treatment.

Prior to getting assessed, you must have reached MMI, and it normally takes 10-12 months after the date of your injury. If you undergo any surgery in between, it might be another 12 months following the surgical procedure before you reach MMI.

If you have a lawyer acting for you, your lawyer will attend to arranging a WPI assessment appointment once you have reached MMI and is ready for a WPI assessment. An IME assessor then assess your injury to work out the WPI percentage.

Once you have been assessed, the IME assessor will forward a copy of an IME report to your lawyer. Upon receipt of the report, if your level of permanent impairment is assessed to be 11% WPI or more for physical injuries (15% WPI or more for psychological injuries), you will be entitled to proceed with a claim for lump sum benefits.

Subject to your instructions, a claim will be made to the workers compensation insurer by your lawyer on behalf of you. The amount of compensation you are entitled to will depend on the WPI percentage rating, and the higher the impairment rating, the higher the lump sum compensation you will receive.

One chance to make a lump sum claim

Please note however, for claims which are made after 19 June 2012, the injured workers are only allowed to have one opportunity to make this claim.

If you have resolved a lump sum claim for impairment and if the claim was made after 19 June 2012, you will not be entitled to make any further lump sum claims for impairment regarding the same injury, even if your condition deteriorates or you undergo a surgical procedure which might increase your impairment rating further in the future.

It is therefore important for you to seek legal advice from an experienced workers compensation lawyer before you go to pursue a lump sum claim for permanent impairment. Alliance Compensation and Litigation Lawyers are highly experienced in workers compensation, and we are committed to helping you get access your full entitlements and managing the process to be as stress-free as possible.

As we can apply for funding from the Independent Review Office (IRO) to cover our legal costs and other expenses associated with WPI assessment appointments, there will be no costs charged to you if you instruct us to pursue a lump sum claim for permanent impairment under the scheme on your behalf.

Please call us on (02) 8764 1776 to book in a free consultation with one of our workers compensation solicitors.