Penrith woman succeeds in claim for lump sum workers compensation and weekly payments

PUBLISHED 16 Mar 2016

One of our workers compensation clients from Penrith area was awarded her maximum possible amount of weekly compensation, and was successful in making a lump sum claim for psychological injuries. She was employed at a supermarket, and had been working there for many years. She suffered a psychological injury as a result of the poor handling of a matter by her managers after she was falsely accused of doing something in the work place. The insurer initially denied the claim stating the injury was not caused by an unreasonable action taken by the employer.

In order to succeed in respect of a psychological claim, the injury needs to be a result of unreasonable actions taken by the employer. The Workers Compensation Act 1987 goes on to define certain actions that are not deemed to be unreasonable, and these include things such as performance appraisals.

Our client has been unable to return to work of any sort following the incident in question, and the insurer had denied her claim within 6 months after the injury occurring.

Having deemed this client to have a reasonably arguable case, the lawyers at Gerard Malouf and Partners obtained funding from the Workers Compensation Independent Review Office (WIRO) to fund the claim. WIRO approved funding, meaning they agreed to pay for all medical reports and clinical records the lawyers required, as well as paying for professional fees.

Once WIRO provided funding, the lawyers at Gerard Malouf and Partners organised an appointment with a medical specialists to comment on what caused the injury, whether the injury was keeping this client from returning to work, and also to comment on whole person impairment.

In order to be successful in making a lump sum claim for psychological injuries, the worker needs to satisfy a whole person impairment of 15% or greater. It is a higher threshold than the 11% needed for a physical injury.

The specialist assessed our client as having over 15% whole person impairment, and due to the insurers continued denial of the claim, the matter proceeded to the Workers Compensation Commission for an Arbitration. Our solicitors garnered the assistance of a barrister for the Arbitration, the cost of which was once again covered by WIRO.

At Arbitration, the solicitor, barrister and client attended along with the insurer’s representative. The matter was heard by an Arbitrator who made a determination in our client’s favour based on the merits of the submissions put forward. On the issue of impairment, the Arbitrator referred our client to an Approved Medical Specialist to comment on whole person impairment.

The Approved Medical Specialist agreed with the original specialist in that the impairment was over 15% and therefore our client was able to make a lump sum claim. This meant that the worker was entitled to a lump sum payment for impairment, along with an award for weekly payments for a period of approximately one and a half years. This was an extremely successful outcome.

Furthermore, as our client was assessed as having over 15% impairment, she is now entitled to investigate a Work Injury Damages claim. This is a claim for negligence against the employer, and if successful, would allow her to claim for past and future economic loss. A worker cannot make a Work Injury Damages claim unless they have an impairment of at least 15%. The threshold to commence a Work Injury Damages claim is the same for both physical and psychological injuries.

The result achieved was what our client was hoping for and it was accomplished without any legal or other cost to our client. She is now seeking to use our services once more to commence a Work Injury Damages claim. If you or anybody you may know has suffered from a psychological injury in the workplace, please do not hesitate to contact the highly experienced solicitors at Gerard Malouf and Partners.

Call us now on 1800 004 878 to book a free appointment with one of my compensation experts, or email your enquiry.