Though there are strict time limitations and period restrictions for different forms of compensation, the limitation period is not so strict in receiving a lump sum payment for impairment under the New South Wales workers compensation scheme. The New South Wales workers compensation law is governed by the Workers Compensation Act, 1987.
Within the 1987 Act, there are restrictions on periods of compensation. Section 39 of the 1987 Act, restricts the period of weekly compensation to 260 payments (5 years) of weekly compensation for those who do not satisfy the category of a worker with ‘high needs’, that is they do not attract an impairment rating of at least 21% whole person impairment. The same restriction can apply even if a worker is likely to reach that threshold of 21%, if the worker is not an “existing recipient” and has not reached maximum medical improvement in order to be assessed on their impairment. An ‘existing recipient’ is an injured worker who was receiving weekly compensation payments prior to 1 October 2012.
Another restriction under the 1987 Act is Section 59A which imposes a restriction on payments of medical expenses, even those that are reasonable and necessary. Entitlements for medical expenses cease after five years has elapsed since the worker last received weekly compensation payments. An example would be if somebody had their weekly payments cease on 25 October 2020, their rights for medical expenses will cease on 25 October 2025. The exception to this time limit are certain medical aids, such as, crutches, artificial members, eyes or teeth and other artificial aids or spectacles and batteries.
The same strictness does not apply when pursuing a lump sum claim for impairment. One of our injured workers who had instructed us after an unsuccessful attempt at a lump sum claim with her previous solicitors was able to receive an outcome and receive a lump sum payment for the impairment sustained. This was the case even though the injury had occurred over 2 decades ago.
Injured worker under the New South Wales workers compensation scheme have an entitlement for only one lump sum claim for impairment after 19 June 2012. If the worker had an injury and received a lump sum for impairment before 19 June 2012, the worker is entitled to one further lump sum benefit after 19 June 2012. This is permitted if there is a deterioration of the injury and hence an increase in the impairment.
If an injured worker had an injury prior to 19 June 2012 and has not received a lump sum payment for impairment, they still have the benefit of one lump sum claim after 19 June 2012.
Of course, an injured worker who had sustained an injury on or after 19 June 2012, is entitled to a lump sum payment.
Entitlements for weekly compensation payments and medical expense entitlements do have a cap on the timeframe, depending on the impairment level. The same time caps does not apply to a benefit for lump sums.
It is important to note that the restriction on a lump sum payment for impairment is dependent upon whether the worker satisfies the required threshold and not when the injury had occurred. Most workers need to satisfy an impairment threshold of 11% whole person impairment.
It is also important to note that the above applies to most workers in New South Wales. However, the time limitations and period restrictions on weekly compensation and medical expenses, the impairment threshold requirement and the restriction to one lump sum claim after 19 June 2012, do not apply to ‘exempt workers’, who make up the minority of workers in New South Wales.
If you or someone that you know had sustained an injury many years ago and there is uncertainty of existing entitlements, contact us and we will take the time to explain to you what entitlements are still available for the injury/claim.
