If you’ve lodged a workers compensation claim and it has been accepted, you have an entitlement to the following:
- Payment of weekly income maintenance (often referred to as weekly payments) for the time you have off work due to your work-related injury;
- Costs in respect of reasonable medical expenses and other associated costs related to your work injury;
- Payment of lump sum compensation for permanent impairment; and
- Compensation for loss of future earning capacity (economic loss).
A lump sum claim for permanent impairment can be confusing for injured workers. Some workers believe that their various other entitlements (weekly payments and medical expenses etc) cease once they receive a lump sum payment.
Put simply, some injured workers believe that by agreeing to accept lump sum compensation, they are agreeing to close off the rest of their workers compensation entitlements.
"Your entitlement to lump sum compensation is provided over and above the other forms of entitlement."
This is definitely not the case.
Your entitlement to lump sum compensation is provided over and above the other forms of entitlement described above. In other words, when you receive a lump sum payment, your entitlement to ongoing income maintenance (weekly payments) and medical assistance continues for the entire term of your claim.
The amount of income maintenance and medical expenses entitlements is bound by legislative requirements and is different for each worker’s specific circumstances.
How do I claim a lump sum payment for permanent impairment?
For you to successfully claim a lump sum payment, there are a number requirements to be met.
A lump sum payment can only be made once medical opinion from a specialist independent medical examiner (IME) has been provided declaring that your injury has stabilised (sometimes referred to as Maximum Medical Improvement).
The IME must provide assessment of the extent of your whole person impairment (WPI) and that assessment, expressed in terms of a percentage, must exceed 5% WPI for you to qualify for any lump sum payment for permanent impairment.
As a very general guide, an assessment of 5% WPI equates to approximately $13,000 lump sum compensation with an incremental increase in the amount for every percentage point exceeding 5%.
If your whole person impairment is assessed at 30% or greater, you will then be deemed “seriously injured” and further entitlements will be available to you which include:
- Income maintenance payments extended to your retirement age; and
- Medical expenses paid for whole of life.
In South Australia, there is no opportunity to claim lump sum compensation for psychological injuries or impairment. However, it may be possible to claim weekly payments and medical expenses for this type of injury.
You may also be entitled to what is called a common law claim for negligence. This is a complex area of the law and if your WPI exceeds 30% you should seek specialised legal advice.