Working in a fast-paced environment such as forestry or an oil rig can be thrilling yet dangerous at the same time. Workplace injuries are not uncommon in these industries. In extreme situations, accidents can cause whole person impairment which could qualify the injured person for
workers’ compensation as it aligns with the Workers Compensation Act. This article will review what whole person impairment compensation looks like in NSW, how to calculate compensation, and what you need to file a claim.
Understanding whole person impairment in NSW
Also known as permanent impairment, whole person impairment occurs when an individual’s physical or mental capacity is inhibited so much that they are unable to perform everyday activities. It can occur in any number of situations that can have a huge impact on your ability to work or lead a normal life.
Worker’s compensation is available after the victim is evaluated, as the degree of impairment will affect the amount they receive. The level of impairment the victim has received as a result of the injury must be assessed by the Compensation Guidelines for Evaluation of Permanent Impairment (1 April 2016).
If your injury happened on or after 19 June 2012, your level of permanent damage must be at 11% or more to qualify for lump sum compensation. If your degree of injury covers 15% of your body or more, you can also qualify for primary psychological injury compensation (non-economic benefits).
However, secondary psychological impairment will not qualify. For example, if your psychological distress is a result of a physical injury, you will not qualify for additional impairment benefit on top of your worker’s whole person impairment compensation payout.
Injuries that could cause physical whole body impairment include:
- Nerve damage.
- Ankle or wrist fusions.
- Joint replacement or spinal surgery.
- Eyesight injuries.
- Arm, leg, elbow, shoulders or knee restricted range of motion.
- Hearing loss on the job.
- Disability covering multiple parts of the body.
Your whole person impairment will be assessed by a licensed professional for both physical and mental injury. A psychological disorder is considered permanent if your doctor determines the injury will continue indefinitely.
To reach a conclusion, the medical professional will consider the likelihood of improvement, how long your condition has lasted so far, and if you have taken any steps toward rehabilitation.
To qualify for compensation with psychological whole body impairment, the injury must affect your concentration, your ability to conduct work and care for yourself. Depression and post-traumatic stress disorder (PTSD) are two conditions that can reach this threshold for benefits.
Types of permanent impairment compensation
Whole person impairment compensation is calculated by the percentage of your body that is permanently injured. You must visit a licensed professional for this type of assessment as part of the legal process to receive benefits. NSW requires victims to have at least 11% impairment unless the injury involves hearing loss — which must reach 5% impairment — or a lost limb — which has no threshold for compensation.
Your level of impairment equates to a certain benefits time limit for
compensation payouts. These details include:
- 0-10% impairment: Up to two years after your injury or up to two years after your weekly benefits end (whichever comes later).
- 11-20% impairment: Up to five years after your initial accident or up to five years after your weekly payouts end (whichever comes later).
- 21% or more impairment: Lifetime coverage up until age 68.
Permanent impairment compensation is meant to cover you if you are unable to perform your job to the same degree you once did (or at all). However, non-economic loss compensation is available as well.
Non-economic loss compensation is meant to compensate you for your loss of quality of life. This benefit includes pain and suffering as well as other qualifying categories:
- Loss of amenities of life.
- Loss of anticipated life plans.
- Disfigurement.
How both economic and non-economic compensation are calculated varies based on the percentage of your injuries but can be broken down into a rough estimate based on averages across NSW.
NSW whole person impairment compensation calculator
Your level of physical impairment is calculated based on the percentage of injury your doctor provides the insurer. Below is an estimated calculation to give you an idea of how much compensation you can expect to receive:
- 0 – 10%: $0
- 11% – 20%: $22,480 – $53,470
- 21% – 30%: $51,880 – $85,570
- 31% – 40%: $83,040 – $138,460
- 41% – 50%: $131,440 – $191,360
- 51% – 60%: $242,010 – $338,100
- 61% – 70%: $376,030 – $484,740
- 71% – 74%: $510,040 – 558,040
- 75% – 100%: $577,050 – $631,370
Non-economic loss is calculated differently. To begin, NSW will not award this type of benefit until you have an impairment of up to 15% or more. The law even acknowledges that the monetary benefit can only go so far as to repair the damages lost with the qualifying phrase, set by the Robinson v Harman [1848] All ER Rep 383, “so far as money can do so.”
Workers’ compensation in particular is paid out in a lump sum payment, where accidents like a motor vehicle crash will be paid in periodic deposits under the
once and forever principle according to the Civil Trials Bench Book — Damages report.
Filing the claim
To file a claim, a permanent impairment form is required which includes information you will need to file. You will not need to fill out this form if the worker’s claim for weekly and other benefits already included a claim for lump sum compensation for permanent impairment.
Information you must provide for public liability claims includes:
- What happened in the event of your injury.
- What the injury is and complications in your life or physical body that have arisen as a result.
- Any previous injuries, conditions or abnormalities that may have caused part of the injury as well as any previous claims you’ve made.
- Past employment that may have caused the injury.
- The report from your permanent impairment assessor about your injuries.
If the injury occurred on or after 1 January 2002, the assessor’s report must include:
- Using the NSW workers compensation guidelines for the evaluation of permanent impairment, the examination results must be set to a percentage of impairment.
- A copy of the audiogram if the injury includes hearing impairment.
- A statement claiming the injury has reached maximum medical improvement.
Insurer’s responsibility in your claim approval
Your insurer plays a major role in determining liability. After they receive your claim for lump sum compensation, they will either accept or deny liability within one month. At this time, they will offer you a reasonable settlement or dispute liability.
The claim resolution process may be extended if the insurer does not believe they have enough information to conclude. If this is the case, the insurer will, within two weeks of receiving the claim, ask you to provide more information or make arrangements for a permanent impairment assessor to look over your injuries and send over a report. After which, they have up to two months to come back with a complying agreement.
A complying agreement is a written understanding between the insurer and you about the percentage of impairment that may result in lump-sum payments to you. Before this conclusion is met, the insurer must be satisfied that you have sought legal advice or waived your right to seek legal advice.
Your compensation lawyer is at your side
Whole person impairment is a complicated, long process of assessment, legal actions and paperwork. When you are recovering from a major accident and looking for help with medical bills, pain and suffering, dealing with the legal details can quickly become overwhelming without legal advice.
Gerard Malouf & Partners is here to help guide you through the process, handle the specifics of your case and fight for your right to full benefits. We are personal injury lawyers that offer a no-obligation consultation to go over your options where cover your case and the steps you need to take.
Gerard Malouf & Partners is a Leading Australian No Win No Fee Law Firm. We specialise in maximising the compensation results from your legal compensation claim.
Make an enquiry or gives us a call today to get started.
