Classification of high needs worker and highest needs worker

An injured worker’s whole person impairment assessment not only affects their entitlement to lump sum compensation but also affects the length of time of their entitlement to medical expenses and weekly payments.

For more significantly injured workers, on top of their entitlements to weekly payments for time periods of incapacity or partial incapacity and related medical expenses, they can also make a lump sum compensation claim for whole person impairment.

If an injured worker is assessed at 11% whole person impairment or greater, their entitlement to medical expenses extends from up two years from their last weekly payment to up to five years from their last weekly payment.

Further, for more seriously injured workers, if their whole person impairment is assessed at 21%-30%, they will be classified as a “high needs worker”.

A high needs worker is entitled to weekly payments until retirement age and medical expenses for life. This though is subject to ongoing WorkCover NSW certificates of capacity, certifying their ongoing incapacity. Further, injured workers must undergo work capacity assessments as arranged by the workers compensation insurer at least every two years.

If an injured worker is assessed at 31% whole person impairment or greater, they will be classified as a “highest needs worker”. Again, the injured worker is entitled to weekly payments until retirement age and medical expenses for life however, they are not subject to the requirement of undergoing work capacity assessments, unless they elect to do this.

Separately, if an injured worker is assessed at 15% whole person impairment or greater, this provides them with the opportunity to make a work injury damages claim, a claim against their employer for negligence which led to the worker’s injury. This is a claim an injured worker can elect to make instead of remaining under the Workers Compensation Scheme and receiving ongoing weekly payments and medical expenses.

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We assist injured workers with their lump sum compensation claim and once this is finalised, provide advice with regard to their options of either remaining under the Workers Compensation Scheme or making a negligence claim.