by Pania Watt
If you have a claim for workers compensation, during your claim you may be asked to submit to an Independent Medical Examination for the purpose of assessing your level of whole person impairment.
Whole person impairment (“WPI”), is also referred to as permanent impairment. A whole person impairment assessment is an assessment of the degree of permanent impairment of any body part, system or function which is impaired as a result of an injury.
What is involved in an assessment?
The insurer, or your solicitor, will refer you to a doctor of a speciality relevant to your injury, who is a SIRA approved assessor of permanent impairment. Generally, this will not be your treating specialist. The list of doctors who are SIRA approved assessors can be found here.
Why do I need an assessment of whole person impairment?
Prior to the changes to the Workers Compensation Act 1987 in 2012, the assessment of whole person impairment was only for the purpose of determining an injured worker’s entitlement to claim lump sum compensation.
Since the changes, an assessment of whole person impairment and (if applicable) payment of lump sum compensation does not finalise your other entitlements to weekly payments and medical expenses, but the assessment itself will determine how long you are entitled to weekly payments and medical expenses (unless you are a Police Officer, a Paramedic or a Firefighter).
How is whole person impairment or permanent impairment assessed?
Your level of permanent impairment is calculated by a doctor who is trained to assess your injury in accordance with the AMA5 and the Workers Compensation Guidelines for assessment of permanent impairment.
The doctor will assess:
1. Whether your injury has reached Maximum Medical Improvement (in other words, it is as good as it’s going to get);
2. Whether the injury or condition results in an impairment;
3. Whether that impairment is permanent;
4. What the degree of permanent impairment is;
5. If applicable, the proportion of permanent impairment due to a previous injury or pre-existing condition.
What does “lump sum compensation” mean?
There are three basic components to a claim for workers compensation – weekly payments, medical expenses, and lump sum compensation.
Lump sum compensation is intended to compensate you for “pain and suffering” as a consequence of your injury. The calculation is made by an independent medical examiner, who is a doctor with the required training and approval to assess permanent impairment in relation to a NSW workers compensation claim. That assessment is evidence, but is not conclusive of your condition, your fitness for work, or any other medical question.
How is the amount of compensation worked out?
In order to claim lump sum compensation for a physical injury, you must be assessed with whole person impairment of 11% or more.
In order to claim lump sum compensation for a psychological injury, you must be assessed with whole person impairment of 15% or more.
The amount of money payable for a certain percentage of impairment is dependent upon the date of the injury, and the type of injury. The amounts payable are set out in the SIRA Workers Compensation Benefits Guide.
The information in this blog is not intended to be legal advice, and should not be taken as such. If you have any queries, contact us now on 1300 15 15 45 to discuss your specific circumstances.
All initial consults with our firm are free of charge and all of our services are No Win, No Pay, with the exception of NSW workers compensation claims, which are funded by WIRO and therefore free to all non-exempt workers covered by the NSW workers compensation scheme.