Whole person impairment

A worker who has sustained an injury that results in permanent impairment may be entitled to receive a lump sum payment as compensation.

This lump sum payment is in addition to weekly payments, medical and related expenses that your Claims Service Provider may be paying to you.

Permanent impairment is a permanent deterioration in the worker's functional abilities as a result of their workplace injury.

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Exempt workers


If the injured worker chooses to pursue a whole person impairment claim, they will need to notify the Claims Service Provider by completing a permanent impairment claim form (PDF, 0.1MB).

They will also need to provide a report from a State Insurance Regulatory Authority (SIRA)-accredited permanent impairment assessor (who specialises in Psychiatry).

The report must include:

  • whether the condition has reached *Maximum Medical Improvement (MMI)
  • whether the compensable injury/condition has resulted in an impairment
  • whether the resultant impairment is permanent
  • the degree of permanent impairment that results from the injury
  • the proportion of permanent impairment that is due to any previous injury, pre-existing condition or abnormality.

For psychological claims, the level of permanent impairment must be greater or equal to 15 per cent for the (whole person impairment) claim to be accepted.

Injured workers are not entitled to make multiple permanent impairment compensation claims. Only one claim can be made for permanent impairment compensation in respect of an injury.

*Maximum Medical Improvement is considered to occur when the condition is well stabilised and is unlikely to change substantially in the next year, with or without medical treatment.

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When the above has been received, the Claims Service Provider has up to two months (depending on the information received) to investigate the whole person impairment claim.

If the Claims Service Provider determines that all required information has not been provided about the claim, they will:

  • Request that the injured worker or their legal representative supply this information, or
  • Arrange for another permanent impairment assessor to examine the injured worker.

The level of whole person impairment accepted by the Claims Service Provider is also used to determine other timeframes such as:

  • how long the injured worker is entitled to receive weekly compensation payments
  • how long the injured worker is entitled to receive medical expenses.

If the injured worker's whole person impairment falls between 15 per cent and 20 per cent, they are entitled to:

  • weekly payments of compensation up to five years
  • medical expenses up to five years after either the date the claim was made, or five years after the last date on which they received weekly payments of compensation, whichever is later.

For individuals who have a whole person impairment of 21 per cent or greater, they are entitled to:

  • weekly payments until 12 months after their retirement age, or subject to the insurer conducting a work capacity decision every two years to assess their capacity to work
  • reasonably necessary medical expenses are payable for life.
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If the Claims Service Provider disputes the level of whole person impairment claimed, the injured worker (or their legal representative) can make an application to the Workers Compensation Commission. The Commission will appoint an independent psychiatrist to complete a final assessment of the level of whole person impairment.

The decision from the Commission is final and will be provided to the Claims Service Provider. 

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Exempt workers: Lump sum compensation payments

This information only applies if your employee is an exempt worker in the Treasury Managed Fund. Exempt workers are a class of worker that can include police officers, paramedics and firefighters. They are not subject to most of the amendments made to the workers compensation acts in 2012 and 2015.

Permanent impairment

At a stage during the claim the worker may be eligible for a lump sum compensation payment.

Lump sum payments may include:

  • permanent impairment sustained as a result of a work-related injury or illness
  • pain and suffering arising from the impairment.

If the worker has suffered a primary psychological injury, a claim for lump sum compensation can only be made when the impairment is assessed by an accredited independent medical examiner as 15 per cent or more.

When your claim service provider receives the claim for lump sum compensation they will acknowledge receipt of it, accept liability and make a reasonable offer of settlement, or they will dispute liability.

In the event the worker is not considered to have reached Maximum Medical Improvement*, the assessment will be deferred, and comment made on the value of additional or different treatment and/or rehabilitation.

*Maximum Medical Improvement is considered to occur when the condition is well stabilised and is unlikely to change substantially in the next year, with or without medical treatment.

If the Claims Service Provider requires more information, they must make this request within two weeks of receiving the claim. They can request it after two weeks, but if they do, they must make a decision on the claim within two months from claim lodgement. 

Pain and suffering

The worker may be eligible for lump sum compensation for any pain and suffering they have due to their permanent impairment.

To be eligible to claim they must have a permanent impairment of 10 per cent or more to have access to a pain and suffering payment.

Please note the eligibility criteria for permanent impairment and pain and suffering payments can vary depending on the date of injury. Please consult your Claims Service Provider for further detail.

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