The Return to Work Act 2014 (SA) (“the RTW Act”) provides that compensation for economic and non economic loss is payable for work injuries sustained on or after 1 July 2015 that are causing a whole person impairment (WPI) of 5% or more.
A worker suffering a permanent impairment from a work injury can request a WPI assessment and a determination for lump sum compensation.
Before impairment is assessed, there must be evidence that the injury has stabilised, or reached maximum medical improvement (MMI). A medical practitioner is qualified to determine if an injury is at MMI. In many cases, the worker’s treating general practitioner will be asked to determine whether an injury is stable and provide their opinion in a brief letter or report.
For an injury that is at MMI, a worker can request a WPI assessment. The worker is also able to nominate the specialist assessor, as long as the assessor is accredited as an impairment assessor with ReturnToWorkSA (RTWSA) and not conflicted. A list of accredited assessors is available under the “Accredited impairment assessors” link here https://www.rtwsa.com/service-providers/assessment-services/impairment-assessment. Only one WPI assessment is permitted for all injuries arising from the same trauma and it is important that a worker makes an informed decision when electing a WPI assessor.
At the WPI assessment, the assessor may perform various test and take measurements to determine the nature and extent of a worker’s impairment. The specialist’s report and assessment of WPI may be reviewed by an independent specialist before a decision is made on the worker’s claim for lump sum compensation.
There are 2 types lump sum compensation – non economic loss (section 58) and economic loss (section 56). To qualify for section 56 and 58 compensation, an injury must be assessed as causing an impairment of at least a 5% WPI.
The amount of compensation is governed by the RTWSA Schedule of Sums.
Section 58 compensation is fixed based on the calendar year of injury and the percentage WPI. To illustrate, below is an extract from the Schedule of Sums providing the amount of section 58 compensation for a WPI assessment between 5 and 10%.
|Degree of WPI||01/07/2015
Section 56 economic loss is assessed based on 3 factors; the prescribed sum for the assessed percentage WPI, an age factor and an hours worked factor. A younger and more seriously injured worker who works on a full time basis will receive more compensation than an older less seriously injured worker. The section 56 determination will specify how the insurance company has calculated the entitlement based on the 3 factors. If there is an error in one or more of the factors then the determination may be compromised.
Also, other factors can influence how a lump sum claim is determined, including the combination of impairments for injuries that arose from the same trauma and where a worker is assessed as suffering a 30% or more WPI.
A worker is entitled to seek legal representation and advice at any stage in a WPI claim. At Turner Freeman, we have a team of workers compensation lawyers who can assist a worker at every stage of the WPI process. For assistance or advice please contact us on 8213 1000.