Permanent impairment claims

If you have sustained a workplace injury or illness that is permanent in nature, then you may be entitled to receive a lump sum payment.

A lump sum payment may be paid in addition to your weekly payments, medical and related expenses that the insurer may be paying you.

Your permanent impairment may be as a result of a physical or psychological injury.

The information below is generalised and the payments you receive may vary based on your circumstances.

Who can make a claim

If you have a work place injury for which you have suffered permanent impairment you may be eligible to lump sum compensation. You must have a minimum level of permanent impairment to be eligible for permanent impairment compensation.

For permanent impairment claims made on or after 19 June 2012, the minimum level is more than 10 per cent permanent impairment, except for primary psychiatric and psychological impairments which require a minimum level of 15 per cent permanent impairment.

To learn more about what we cover, see eligibility for workers insurance.

How to claim

To make a claim, complete a permanent impairment claim form.

If your claim for weekly and other benefits has already included a claim for permanent impairment, you don’t need to fill out this form.

Your employer is required to send your claim and any documentation provided in support of your claim to their workers compensation insurer.

Multiple claims

You can only make one claim for permanent impairment compensation per injury.

Workers who made a claim for permanent impairment before 19 June 2012 can make one further permanent impairment claim for a deterioration of their injury.

Exempt workers

If you’re a police officer, paramedic, fire fighter, volunteer bush fire fighter or emergency rescue services volunteer, you are considered an exempt worker.

All exempt workers should complete the exempt claimant permanent impairment claim form.

Exempt workers may be entitled to make more than one lump sum compensation claim and there is no minimum level of permanent impairment to make a claim.

Different rates apply for exempt workers, see below under how much could you receive. 

What happens after you claim

Once your employer's insurer has received your claim for lump sum compensation for permanent impairment, and all relevant information has been provided, the insurer has two months to dispute liability or make an offer of settlement.

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

  • ask you to supply this information, and/or
  • arrange for a permanent impairment assessor to examine you.

You will be asked to provide this information within two weeks of the insurer receiving your claim.

 

Complying agreement

A complying agreement is a written agreement between yourself and the insurer regarding the offer of settlement for a lump sum payment for permanent impairment and, if eligible, for pain and suffering.

Prior to making the payment for permanent impairment, the insurer must be satisfied that you have obtained independent legal advice or have waived the right to independent legal advice.The insurer is required to record evidence that this advice has been obtained, or that you waive your right to obtain the advice, and the details of the agreement.

How much could you receive

The maximum lump sum payment for permanent impairment injuries incurred:

  • between 1 January 2002 and 31 December 2006 is $200,000, with an additional five per cent compensation for permanent impairment of the back for injuries on or after 1 January 2006
  • between 1 January 2007 and 4 August 2015 or all exempt worker claims is $220,000 (plus an additional five per cent for permanent impairment of the back)
  • on or after 5 August 2015 is $584,580 (plus an additional five per cent compensation for permanent impairment of the back), this amount is indexed yearly as of 01/07/16 and is not applicable to exempt workers.

Find out more about lump sum payments.

Additional payments for pain and suffering

If you’re an exempt worker, you may also receive an additional lump sum payment for pain and suffering arising from permanent impairment if you have 10 per cent or more whole person impairment.

For a primary psychiatric and psychological impairment there is a 15 per cent threshold.

The maximum amount payable is $50,000.

Getting legal advice

Most workers are responsible for covering their own legal costs, but in some circumstances you may be able to access free, independent legal advice through the Independent Legal Assistance and Review Service (ILARS) run by the Workers Compensation Independent Review Office (WIRO).

Legal advice may be available through the provision of a grant, if you disagree with a decision the insurer made about your claim for a lump sum compensation for permanent impairment.

The ILARS service applies to non-exempt workers only. The Workers Compensation Commission has authority to order the insurer pay the legal costs for exempt workers in accordance with scheduled rates.

You can call WIRO on 13 94 76 or visit their website www.wiro.nsw.gov.au.