Understanding the Comcare Whole Person Impairment Assessment Process
If you have a permanent impairment resulting from a work injury, you may be eligible for a Whole Person Impairment (WPI) Assessment. Seeking advice from lawyers with expertise and experience with Comcare claims is crucial to ensure that you receive the maximum compensation payable.
Permanent Impairment Claims and Comcare
In certain circumstances, if you have sustained a significant injury at work you may be entitled to a permanent impairment claim, also known as a ‘whole person impairment’ payment. This is a lump sum payment that is payable to you, the amount of which generally reflects the severity of your injury or injuries.
There is a formal process involved in making a claim for a permanent impairment, which includes completing various forms and obtaining relevant medical evidence.
This type of claim is usually only paid once so it is important it is done properly.
The minimum ‘impairment’ you must have to receive such a payment is 10% impairment, assessed in accordance with the relevant Comcare guidelines and tables.
If you receive a WPI lump sum payment, you are still entitled to claim weekly payments and medical expenses relating to your accepted injury claim.
Your claim is not closed or finished simply because you receive this payment.
Under the Comcare system, injured workers can make a permanent impairment claim for both psychiatric injuries as well as physical injuries.
Understanding WPI Assessment and Psychiatric Injury Claims
To reach 10% Whole Person Impairment on a psychiatric injury claim, the relevant Guide to the Assessment of the Degree of Permanent Impairment sets out that if the worker experiences two out of the following three criteria, compensation is essentially payable:
- reactions to stresses of daily living with minor loss of personal or social efficiency;
- lack of conscience directed behaviour without harm to community or self;
- minor distortions of thinking.
The above criteria is not straight forward, and it is important to seek legal advice if you have a psychiatric work injury under the Comcare system and wish to pursue a WPI assessment claim. Having legal advice will ensure the process runs as smoothly as possible and will maximise your chances of being awarded compensation.
The Assessment Process
The WPI assessment process typically involves several steps:
- Permanent Impairment Claim Forms are to be completed by the injured worker and treating doctor.
- An Independent Medical Examination is then undertaken by an independent specialist.
- A rating of impairment defined as a percentage is provided and typically documented in a comprehensive report that outlines the findings of the medical examination and the assigned impairment rating. This report is then submitted to Comcare for review and a determination is then made.
- If an assessment of 10% impairment or more is determined, compensation is payable.
Conclusion
The WPI assessment is a critical component of the Comcare scheme, providing a standard method for evaluating the extent of impairment resulting from workplace injuries or illnesses.
Why should I engage a lawyer?
Permanent impairment claims are generally complex and involve a number of important considerations. It is essential to get good advice and follow the process strictly, as they are usually only paid once.
You have the right to challenge the determination if it is not correct in law, and a lawyer will be best placed to advise and assist with this process.
At TGB Lawyers, we frequently assist people with the permanent impairment process and provide advice and assistance with any appeals to the Administrative Appeals Tribunal if the Determination has not been calculated appropriately by the insurer.
Get in touch!
If you have a work injury, it is worth seeking legal advice to help you navigate through the complex claims process.
Tindall Gask Bentley has been practising workers compensation law for over 50 years, so don’t hesitate to get in touch with us. You can let us know here that you’d like to chat and we’ll contact you, or feel free to contact our SA Workers Compensation team on (08) 8212 1077. Alternatively, you can contact Alex Harris direct on aharris@tgb.com.au