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.   

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