WorkCover lump sum payments in Victoria

Under the WorkCover scheme in Victoria, there’s two potential lump sum payments that you may be able to access if you’ve been injured.

The first is called an impairment benefit and the second is called a common law claim for damages.

This post will go to some detail about both of the WorkCover lump sum payments available to injured workers in Victoria. They are both very different.

Impairment benefits claim

An impairment benefit claim is open to someone if they have a work related injury or illness that has resulted in permanent impairment.

It doesn’t matter whether you’re at fault or not for the injury or illness. Anyone that is injured at work is able to pursue a claim for impairment benefits.

An impairment benefit payment is separate to any other WorkCover entitlements and does not count as income.

In order to be entitled to impairment benefit, any injuries or conditions need to be graded by specialist doctors who will put percentage figures on your injuries or conditions.

These percentage figures will then get combined into one overall figure. This overall figure must then reach a threshold level of impairment in order for you to succeed.

The higher the overall figure that you received, the greater the chance of success in this claim and the more that the WorkCover Insurer will pay.

Your injuries as mentioned above will need to be graded by specialist doctors who have undergone certain training which allows them to grade injuries in legal matters.

You are not able to have your own treating doctors, including your own specialist, grade your injuries.

Generally speaking, a claim for impairment benefits takes about 2 to 4 months to finalise and in the vast majority of cases does not require going court.

If after the initial assessment or assessments by the doctors, you are not happy with the offer that the insurer has made, then it is possible appeal the assessment or assessments to what is called the medical panel.

This basically involves being assessed by 2 to 3 doctors, sometimes more, at the one time.

They review any assessments that were done on you previously and form their own opinion. They will either increase decrease or keep the same the previous opinion.

Generally the opinion of the medical panel is final and binding. However in some limited cases an opinion can be appealed.

Common law damages claim

The second potential lump sum WorkCover payment in Victoria is called a common law claim for damages.

This claim is very different to an impairment claim.

With an impairment claim you do not need to show that someone else was negligent and that their negligence contributed to your injury.

Whereas with a common-law claim, you must show that there was negligence on behalf of another party in order to succeed.

If you fail to prove that another party was negligent, you will not succeed in your case.

The second thing that you must prove to succeed in a common law claim is it the injury that you suffered is a serious one. Again, if you’re not able to prove this you will lose your case.

If you see succeed in showing that there was both negligence AND that you sustained a serious injury as a consequence, then you can be compensated for pain and suffering and loss of earnings that you have experienced and will likely experience.

Pain and suffering is calculated based on previous cases that have come before you.

So if you have a lawyer, part of their job is to work out what your pain and suffering consequences are based on previous cases.

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In relation to your loss of earnings, it is complicated to work out in some cases.

It needs to take into consideration the fact that you might not work until retirement age or that you might not even leave until retirement age.

In general, when calculating loss of earnings there’s certain formula that are used.

Any common law claims need to be initiated with in six years from the date of injury. There are some exceptions to this rule but as a general principle, six years is what you get.

These claims sometimes end up in court but more often than not they settle before hand.

Of the two WorkCover lump sum payments, which should I choose? 

This depends. 

Sometimes only an impairment lump sum should be pursued because a common law claim would likely fail (either due to there being no negligence or because the injury could not be considered ‘serious’).

Other times, people can and should consider pursuing both an impairment claim and a common law claim.

In certain cases, it might make sense to skip the lodgement of an impairment claim and go straight to the lodgement of a common law claim. Best to seek legal advice in relation to this.