NSW Workers Compensation: Introduction to the assessment of Whole Person Impairment (“WPI”) – Part 1

How much lump sum compensation am I entitled to? This is often the first question we get asked by our clients. The answer is – it depends on your level of WPI. So, what is WPI and how is it assessed? What are the principles of the assessment of your level of permanent impairment? At Littles Lawyers we will dissect this for you and provide a series on the background of WPI assessment and how the most common injured bodily areas are assessed.  

Firstly, the guidelines that all Medical Assessors are required to follow in order to assess your level of WPI is the revised 4th edition of the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment (“the Guidelines”). The Guidelines adopted the 5th edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment (commonly known as the AMA5).  

When it comes to assessment of permanent impairment, there are some key principles that all Medical Assessors are required to consider and assess on the day of the assessment: 

  1.  Whether the Claimant’s medical condition has reached ‘Maximum Medical Improvement’ (“MMI”) – we will explain what this means later;  
  2.  Whether the Claimant’s compensation injury/condition has resulted in an impairment; 
  3. Whether the impairment is permanent or temporary;  
  4. The degree of permanent impairment that results from the injury; 
  5. Whether any consideration or apportionment are required to be applied due to any previous injury and/or pre-existing conditions.

 

The Medical Assessor is required to exercise their clinical judgement on the day of the assessment, taking into account the Claimant’s presentation on the day, the relevant medical history and all relevant material available to him/her when assessing the level of WPI. 

What is ‘Maximum Medical Improvement’?

Maximum Medical Improvement (“MMI”) is considered to occur when the worker’s medical condition is well stabilized and is unlikely to change substantially in the next year with or without medical treatment.  

The Medical Assessor is only able to assess the level of ‘permanent’ impairment when the condition has stabilized, otherwise it is arguable whether the impairment is indeed ‘permanent’ or perhaps ‘temporary’ only.  

One question we often get asked as lawyers is “when will I get assessed?” The answer is – it depends when you have exhausted all medical treatment option. This does not mean we have to wait until you have completed all your treatment plans. There are some allied health treatments that will unlikely alter your level of impairment (for e.g. physiotherapy), whilst some other treatment (for e.g. surgery) will most likely alter your level of impairment.  

As we know, most injured workers are only entitled to make one lump sum permanent impairment claim for any injuries after 19 June 2012, and therefore it is crucial that you only get assessed when you have undergone all the treatment proposed by your doctors and medical practitioners, so we can accurately assess your level of WPI and maximise your entitlement to lump sum compensation.  

To avoid delaying the progress of your claim, as a Claimant it is important that you are proactive with seeking and undergoing treatment as we are unable to arrange for that assessment of WPI until you have reached MMI.  

The Head of our NSW team, Jessica Cheung is an Accredited Specialist in Personal Injury Law specializing in workplace injuries. If you believe you have sustained a work-related injury and would like professional legal, reach out to Jessica and her team for a confidential discussion at no costs to you.   

Like? Share it with your friends.

Contact the Author

Topics

More Articles

纤维肌痛症(Fibromyalgia)以及退休金保险 – TPD 

纤维肌痛(Fibromyalgia)是什么? 纤维肌痛症是一种弥漫性肌肉骨骼疼痛的疾病。其伴随症状包括疲劳以及记忆、睡眠和情绪问题。  纤维肌痛并没有明显以及固定的诱发因素。有些病患是因为单一事件后开始出现症状,有些则是随时间推移慢慢出现相关症状并愈发严重。  目前的医学发展无法根治纤维肌痛症,现有的治疗主要是通过药物控制症状。 纤维肌痛患者可以申请TPD保险赔偿吗 ?了解您的权利 首先,大部分的残疾保险并不由病因决定索赔的成败。这表示导致您无法工作的疾病或者受伤的因素并不起决定性的作用。  如果您被确诊患上纤维肌痛,引起伤残问题导致无法回到您原来受的教育、训练以及经验相关的工作,那您有可能可以针对您的完全和永久性伤残保险(Total and Permanent Disability Insurance, 以下简称TPD保险)进行索赔。  由于纤维肌痛的确诊以及症状比较存在争议,为了保障您的权益,获得法律建议以及熟悉相关疾病的医生至关重要。  以上的信息也同样适用于患有复杂性局部疼痛综合征(简称CRPS)以及慢性疲劳综合征(简称CFS)的患者。  退休金以及各类保险的分别 很多人不清楚自己的退休金(superannuation)到底包含了什么投资以及保险。每一个退休金机构(super fund) 对于选购保险的运作方式不同,所提供的保险种类、计划以及福利也不尽相同。所以,您需要了解到底您的退休金机构自带的保险 (default...

Read More

การบาดเจ็บในที่ทำงานและการเรียกร้องค่าสินไหมทดแทนจากประกันภัย TPD

รู้หรือไม่ หากคุณมีอาการเจ็บป่วยหรือได้รับบาดเจ็บจากการทำงาน คุณอาจมีสิทธิ์เรียกร้องค่าสินไหมทดแทนสำหรับพนักงานได้  อย่างไรก็ตามในหลายครั้ง ๆ บางท่านอาจไม่ทราบว่าตัวเองนั้นอาจจะได้รับผลประโยชน์จากประกันภัยทุพพลภาพถาวรสิ้นเชิง หรือที่เรียกว่า TPD (Total and Permanent Disability) ซึ่ง TPD นั้นหมายความว่าคุณจำเป็นต้องหยุดทำงานเนื่องจากอาการบาดเจ็บที่เกิดขึ้น ที่บริษัท Littles เราเป็นผู้เชี่ยวชาญด้านกฎหมายว่าด้วยการเรียกร้องค่าชดเชย การเรียกร้องค่าเสียหาย หรือค่าสินไหมทดแทน...

Read More