An assessment of whole person impairment (“WPI”) can impact on a worker’s compensation claim and the ongoing benefits a worker may be entitled to receive.

An assessment of WPI is commonly investigated initially by the worker’s solicitors. However, at times, the workers compensation insurer may obtain an assessment of WPI to determine the worker’s ongoing benefits. If the assessments vary, an Application to Resolve a Dispute can be filed in the Personal Injury Commission to determine a worker’s WPI.

The assessment is conducted by a medical assessor who is trained, approved and accredited to assess whole person impairment. WPI is assessed in accordance with the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment (“the Guidelines”) which is largely based on the American Medical Association Guidelines for Evaluation of Permanent Impairment, 5th Edition in most cases. Where there is a deviation, the difference is defined in the Guidelines and the procedures detailed in each section are to prevail.

How does WPI impact on my weekly benefits?

0% – 20%

A worker may be entitled to receive up to 130 weeks of weekly wage loss benefits.

For a worker to receive weekly wage loss benefits for 130 – 260 weeks, a worker must either be:

  • Unfit for all work and unlikely to ever work again; or
  • Work 15 hours or more per week and is earning at least $202.00 (as indexed).

If a worker’s injuries are not assessed as being greater than 20% WPI (i.e 21% or greater), the weekly wage loss benefits are limited to a maximum of 260 weeks (or 5 years). However, this is subject to the above as well as production of certificates of capacity which certifies a worker’s capacity.

21% or greater

If a worker’s injuries are assessed as being greater than 20% WPI, weekly wage loss benefits may continue beyond 260 weeks. However, this is subject to the insurer conducting a work capacity assessment as well as production of certificates of capacity.

How does WPI impact on my medical , hospital and rehabilitation (treatment) expenses?

0% – 10%

If a worker has not received an assessment of WPI or if the worker is assessed as being between 0% – 10% WPI, treatment expenses will cease 2 years after the last date a worker received weekly wage loss benefits (or the date of injury if the worker has not been in receipt of wage loss benefits).

11% – 20%

If a worker has received an assessment between 11% – 20% WPI, treatment expenses will cease 5 years after the last date a worker received weekly wage loss benefits (or the date of injury if the worker has not been in receipt of wage loss benefits).

21% or greater

If a worker is assessed as being greater than 20% WPI (i.e 21% or greater), there is no time limit on claiming treatment expenses.

Further, the time limitation on medical expenses does not apply to any compensation sought in respect of the following treatment:

  • Provision of crutches, artificial members, eyes or teeth and other artificial aids or spectacles (including hearing aids and hearing aid batteries);
  • The modification of a home or vehicle;
  • Secondary surgery, which must be directly consequential on the earlier surgery and must be approved by the insurer within two years after the earlier surgery was approved.

The above is subject to the insurer determining that the medical expenses are reasonably necessary.

How does WPI impact on my ability to claim to Lump Sum Compensation?

Physical Injuries

If a worker’s injuries are assessed as being greater than 10% WPI (i.e. 11% or greater), a worker may be entitled to pursue a claim for lump sum compensation. This is subject to the insurer agreeing or the Personal Injury Commission determining a worker’s level of impairment.

Psychological Injuries

If a worker’s primary psychological injuries are assessed as being at least 15% WPI, a worker may be entitled to pursue a claim for lump sum compensation. This is subject to the insurer agreeing or the Personal Injury Commission determining a worker’s level of impairment.

Physical and psychological injury assessments arising from the same incident cannot be combined to create a greater assessment of WPI.

How does WPI impact on my ability to claim Work Injury Damages?

If is agreed or determined that you suffer at least 15% WPI, you may be entitled to bring a separate claim for work injury damages (i.e. negligence).

Get in touch with us

At Turner Freeman, we have specialist personal injury lawyers who will assess your case and provide personalised advice regarding your legal entitlements.  Our lawyers are located across NSW including in our offices in Sydney, Parramatta, Wollongong, Newcastle and Toronto. Call us today on 13 43 63.