WorkCover payouts for shoulder injuries
Under the WorkCover system, if you succeed in an impairment lump sum for a shoulder injury, you can expect to receive a minimum of $21,000. You may be entitled to more if your shoulder injury is particularly bad (eg: one that required surgery).
If you succeed in a common law lump claim for a shoulder injury, you can expect to receive somewhere between $80,000 – $200,000 on a pain and suffering only basis. How much exactly you will be entitled to will depend upon the extent to which the injury impacts your life.
In addition, you may also be entitled to be compensated for loss of income. How much depends upon how your shoulder injury impacts your work capacity into the future.
Shoulder injuries that occur in connection to employment a very common.
If you’ve suffered a shoulder injury at work, and if you have an accepted WorkCover claim relating to the shoulder injury, there are two potential lump sum‘s that you may be able to pursue.
The first is called a claim for impairment benefits, and the second is called a common-law claim for damages.
The rest of this article will discuss both WorkCover payouts for shoulder injuries suffered as a result of employment in Victoria.
Table of Contents
Impairment claim for shoulder injury
An impairment claim is a lump sum for permanent impairment.
You may be entitled to pursue an impairment claim if you’ve suffered some sort of permanent impairment to the shoulder.
In order to pursue an impairment claim for your shoulder injury, you do not need to show that the injury was caused or contributed to by someone else’s negligence.
An impairment claim can be pursued regardless as to whether there is negligence or not.
The way that an impairment claim works is you first would need to lodge the impairment claim form.
On the impairment claim form you would specify the nature of your injury and how it happened.
You would also specify what doctors have treated your shoulder and whether you’ve had any previous injuries that may relate to your shoulder injury.
That claim form then gets sent off to the relevant employer and insurance company.
It’s then up to the insurance company to process your claim which involves arranging an appointment for you to see an IME doctor to assess your shoulder injury.
Typically, you will have an appointment arranged to see an orthopaedic surgeon. The surgeon will assess your shoulder injury and grade it. They will put a percentage figure on it.
You might be surprised with the assessment percentage that the doctor puts on your shoulder injury.
Many people are under the impression that the percentage figure will be out of 100. So if their injury gets assessed at 5%, they mistakingly believe that means their injury is rated as 5/100 – which is not how things work.
So it’s a mistake to think of whatever percent your injury is graded at as being out of 100%.
Anyway, once the doctor has completed their report they will send it to the insurance company.
The insurance company will then send you or your lawyer if you have one a letter with an offer to resolve your shoulder impairment claim.
At this point, you can either accept or reject the assessment. If you accept the assessment your shoulder injury impairment claim is finalised and you’ll generally receive your settlement funds within 2 to 3 weeks.
If you elect to reject the assessment, then your matter will get referred to what’s called the medical panel. The medical panel will involve seeing a few doctors at the one time. These doctors will review the assessment of your shoulder injury completed by the independent medical examiner and either increase it, decrease it or keep it the same.
After the assessment, you will receive notification of the panels opinion in a few weeks. You will receive a letter from the insurance company advising you.
At this point, you can accept the medical panels assessment or in some cases you can appeal their assessment although appealing a medical panel assessment relating to an impairment assessment is rare.
What am I likely to be assessed at for a shoulder injury impairment claim?
In order to be entitled to compensation for a shoulder injury, you must be assessed as having a 10% whole person impairment rating or greater.
Therefore, the minimum amount of compensation that you will receive, if you are successful in relation to an impairment claim for your shoulder injury is $21,560 (2021).
Common law claim for your shoulder injury
The second lump sum that you can potentially pursue if you have injured your shoulder is a common-law claim for damages.
You should have a WorkCover lawyer if you intend to pursue a common law claim. These claims can be complex and as such it is not a claim that you should be pursuing yourself.
Order to succeed in this claim you would need to show that your shoulder injury is a serious injury. The term serious injury is to find under the law and you can read more about that here.
To give you a general idea as to what might be a serious injury, consider how you were before you suffered your shoulder injury and compare that to how you are now. The bigger the difference between the two the more likely it is that you have a serious injury.
The second thing that must be proved is that you suffered your shoulder injury as a consequence Or contributed to by someone else’s negligence. That is, there must be fault.
What am I likely to be assessed at for a shoulder injury common law claim?
This is a complex question with no simple answer.
The reason for this is that there are a number of variables to consider.
Some of these variables, generally speaking, are:
- The nature of the shoulder injury (eg: was it operated on or not?)
- How it happened – what was the negligence that caused the injury?
- Whether you contributed in some way to the injury
- What impact does the injury have on your life?
For a common law claim, there are 2 potential things that you can be compensated for.
The first is for the pain and suffering that you’ve gone through and will go through as a consequence of your shoulder injury.
To give you a very rough idea as to what you may be entitled to by way of common-law compensation for pain and suffering relating to a shoulder injury, the average range is roughly between $80,000 and $200,000.
Keep in mind that the range above is just designed to give you a very general idea. Some shoulder injury common law matters fall outside that range, both below and above.
The maximum amount you can be compensated for pain and suffering is $543,000.
The second is for any lost earnings that result from your shoulder injury.
This is much harder to put a figure on than the pain and suffering component as your lost earnings may only be for a very short period of time or they could be for many years.
Another consideration is how much you’re actually losing per year. Some people may be on $30,000 per year, while others may be on $100,000 per year.
The maximum amount you can be compensated for loss of earnings is $1,249,310.