WorkCover and 30% impairment rating

There are two aspects of a WorkCover claim where being assessed as having a 30% whole person impairment rating is highly relevant.

This page will explore both aspects.

How would you be assessed as having a 30% impairment?

When you refer to being assessed as having a 30% whole person impairment rating, in most cases when it comes to a WorkCover claim in Victoria what you’re referring to Is being assessed in relation to an impairment lump sum claim.

You can read about impairment lump sum claims here.

In a nutshell, what happens is that once you’ve lodged an impairment claim the WorkCover Insurer will organise an appointment or appointments for you to be medically assessed.

The purpose of the medical assessment or assessments is so all of the claimed injuries and conditions can be assessed by medical professionals.

You will need to see a specialist doctor for each type of injury or condition.

For example, if you have a back injury will likely be asked to see an orthopaedic surgeon or a general surgeon.

If you have a psychological injury you will be asked to see a psychiatrist.

If you have multiple injuries or conditions, you will need to likely see different doctors each with the ability to assess your particular injuries or conditions.

Each injury or condition that you are claiming will need to have a percentage figure put on it.

These percentage figures then get combined into one overall impairment figure, called your whole person impairment rating.

In relation to being assessed as having a 30% whole person impairment rating, you can achieve this with one injury or multiple injuries added together.

So if you have a number of physical injuries, the percentage figures for each of these injuries can be added together.

Also different types of injuries can be added together.

So for example if you suffered a psychological injury in certain cases your whole person impairment rating relating to the psychiatric or psychological injury can be added to the physical injury.

It’s important to note however the difference between primary psychological injury and secondary psychological injury.

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Primary psychological injury would be if you witnessed a traumatic incident at work and as a direct result you suffered PTSD.

Secondary psychological injury would be if you suffered a back injury and as a consequence of that back injury you suffered depression.

For the purposes of an impairment claim, you can only take primary psychological injury into account and secondary psychological injury must be disentangled and not included in any final whole person impairment rating.

What happens if I’m assessed as having a 30% in relation to an impairment claim?

If you have a physical injury or a combination of injuries and you are assessed as having a 30% whole person impairment rating, then you’ll be entitled to a lump sum of $86,360.

The threshold level of impairment necessary in order to be entitled to compensation for a physical injury is 5 or 10% depending upon the nature of the injury or injuries.

The necessary threshold level of impairment however when it comes to psychological injuries is 30%.

This means that you need to be assessed as having a 30% or greater primary psychological impairment in order to be entitled to compensation.

What impact does being assessed as having a 30% whole person impairment rating have in relation to a common law claim?

You can read about common law claims in detail here.

There are two things you must show to succeed in a common law claim.

The first is that you are considered to have a serious injury.

The second is that there was negligence on behalf of another party that contributed to your injury or injuries.

If you were assessed as having a 30% or greater whole person impairment rating in relation to an impairment claim, you are considered as having a serious injury and you will be provided with a serious injury certificate by the Victorian WorkCover authority.

In order to obtain a serious injury certificate you (more specifically, your lawyers) will need to lodge a serious injury application.

Being assessed as having a 30% or greater whole person impairment rating and obtaining a serious injury certificate this way can save a lot of time.

If you were not assessed as having a 30% or greater whole person impairment rating, what you would need do is lodge a serious injury application on the Victorian WorkCover authority.

They then would have 120 days to make a decision in relation to whether to provide you with a serious injury certificate or not.

If they determine that you don’t have a serious injury and elect not to provide you with a serious injury certificate, then you’ll need to issue County Court proceedings to have a Judge determine whether you have a serious injury or not.

This can add another six to twelve months potentially to your claim.

Assuming you have been assessed as having a 30% or greater whole person impairment rating in relation to an impairment claim, then what will happen once the serious injury application has been lodged and the Victorian WorkCover Authority’s lawyers have provided you with a serious injury certificate is that your matter will proceed to a settlement conference.

There is the potential that the matter may resolve at this conference.

It’s important to keep in mind that most people that go through the WorkCover system do not get assessed as having a 30% or greater whole person impairment rating.

It is a very significant assessment.

Conclusion

When reference is made to being assessed as having a 30% impairment, this relates to being assessed in relation to a WorkCover impairment lump sum claim.

A 30% impairment is the minimum threshold impairment level necessary to be entitled to an impairment lump sum claim if you have a psychological injury.

If you have been assessed as having a 30% or greater whole person impairment rating, whether you have a physical injury or a psychological injury or a combination of the two, you are also considered as having a serious injury and will be provided with a serious injury certificate once you have lodged a serious injury application.

For the purposes of a common law claim, you need to show that you have a serious injury and obtain a serious injury certificate and also there needs to be negligence on behalf of another party.