If you are receiving workers compensation from an injury that has significantly altered your ongoing quality of life, you may be entitled to a Whole Person Impairment lump sum payment in NSW.
If you believe you may be eligible for whole person impairment compensation, you should contact an experienced legal professional at like Burke Mead Lawyers today. Experienced personal injury lawyers are able to assist you in receiving your full entitlements and adequate compensation.
What is Whole Person Impairment?
Whole Person Impairment (WPI) is a scale utilised for Workers’ Compensation claims measuring the degree of impairment suffered as a result of an injury or illness. This determines the entitlement of the individual to a whole person impairment payment, which is a lump sum compensation in relation to the overall effects of the injury on the individual’s everyday life. This whole person impairment is evaluated based on the NSW Workers Compensation Guidelines for the evaluation of permanent impairment.
If you’re injured at work in NSW, depending on your whole person impairment rating (also known as permanent whole person impairment compensation rating), you might be entitled to a lump sum benefit up to a maximum of $665,260 (maximum amount for claims made after July 1 2022).
What is a WPI Assessment?
A WPI Assessment refers to the evaluation of the overall effects of an injury on an individual, as determined by a medical professional to assess the amount of compensation they are entitled to. For an individual in NSW to be eligible for a WPI payment, they must have 11% or more whole person impairment for a physical injury or 15% or more for a primary psychological injury. For emergency service workers, the threshold for physical injuries reduces to 1%.
Whole Person Impairment (WPI) payouts in NSW are compensation for injuries suffered at work or as a result of your employment. These entitlements are therefore subject to you being able to prove that your time off work or need for treatment/therapy arises due to your work-related injury.
For weekly wage compensation payments, this requires you to obtain a WorkCover Certificate of Capacity from your Nominated Treatment Provider, certifying your work injury-related pain and suffering and incapacity. Also, some medical expenses require pre-approval from the insurer, whilst all expenses require medical support to confirm they are reasonably necessary due to injury.
Weekly Wage Compensation
When it comes to Whole Person Impairment, compensation may include weekly entitlements. These entitlements, and how long they last for, are dependent on the level of impairment.
130 weeks with the potential for a further 130 weeks (260 weeks in total) if the insurer determines you are either:
130 weeks with the potential for a further entitlement up to aged pension age (plus 12 months), if the insurer determines you are either:
130 weeks with the potential for a further entitlement up to aged pension age (plus 12 months), if you are either:
How is Whole Person Impairment Calculated?
In NSW, whole person impairment is calculated by a medical professional who assesses your injuries in accordance with the NSW compensation guidelines for evaluation of permanent impairment. This assessment is to take place once the injury has stabilised so that it won’t improve or deteriorate in the next year with or without treatment.
The medical assessors then follow the guidelines outlined in the Evaluation of Permanent Impairment to obtain a percentage whole person impairment assessment. The percentage of whole person impairment that results from the injury must be determined using the tables, graphs and methodology outlined in the guidelines.
WPI Rating System
The whole person impairment (WPI) scale is a rating system used to measure the amount of permanent damage caused by your injuries. This system is calculated based on the loss, or loss of use of any part of your body or any part of your bodily system or function.
When a doctor is assessing an individual’s eligibility for a Whole Person Impairment (WPI) payout, they must look at the following criteria:
- Has your condition reached maximum medical improvement (MMI)? Or in other words, has your injury stabilised, and is your condition unlikely to improve?
- Do you have an impairment because of your injury?
- If so, is this impairment permanent?
- To what degree are you permanently impaired?
- Is your permanent impairment partly due to a previous injury or condition?
After completing your assessment and answering these questions, the doctor will determine your own level of whole person and impairment percentage using the tables, graphs and methodology given in the guidelines.
What are the Implications of Whole Person Impairment?
If the injury that caused your Whole Person Impairment was sustained as a result of the negligence of your employer, this may result in legal implications as you may be entitled to pursue a claim for negligence against your employer, known as a Work Injury Damages claim. You can only make such a claim if you have a whole person impairment of 15% or greater.
After receiving a WPI payout, workers will still continue to receive weekly payments, medical entitlements and other compensation as a result of their injury. The limit of entitlement to this compensation is associated with the degree of WPI assessable, and at some point during the lifetime of your claim the insurer will make a decision as to your ongoing right to compensation.
Your level of permanent impairment compensation equates to a certain benefits time limit for compensation payouts. These details include:
- 0-10% impairment: Up to two years after your injury or up to two years after your weekly benefits end (whichever comes later).
- 11-20% impairment: Weekly payments for up to five years after your initial accident and medical treat expenses up to five years after your weekly payouts end.
- 21% or more impairment: Lifetime medical coverage and weekly payments up until age 68.
The insurer must provide you with a decision in writing, whenever the decision is unfavourable to your claim. If a written decision is not provided, you should ask for one. If the insurer makes a decision to suspend your entitlements due to your WPI rating, then it is appropriate to obtain legal advice immediately.
You may have the right to obtain a medical assessment of your own to verify the insurer’s WPI assessment. If you receive a decision from the insurer or otherwise consider that you have an injury that will attract a WPI rating of 11% WPI or greater, then we suggest you contact our office to obtain legal advice as to the options available.
Need Help with Your Compensation Claim? Call Burke Mead Lawyers Today!
If you have suffered a permanent injury as a result of your work, and wish to submit a permanent impairment claim, contact the team at Burke Mead Lawyers today. Our expert professionals will provide invaluable guidance and assistance throughout the claims process.
About the Author
Sean is a member of the personal injury team with extensive experience in representing injured clients at the Personal Injury Commission as well as in the District and Supreme Courts of NSW.