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Lump Sum Compensation Payments

Impairment Benefits

In certain circumstances, lump-sum compensation may be paid for permanent impairment of a part of your body.

This compensation is only paid if:

  • your condition has stabilised, AND
  • you are assessed as having a 10% whole person impairment (30% in the case of psychological impairment), OR
  • you have suffered a total loss of effective use of a body part including an amputation.

If you have an injury to your hands, arms, legs, feet or spine which occurred after 3 December 2003, you will receive compensation if you are assessed at 5% whole person impairment or more.

Accepting an impairment benefit does not affect your other entitlements.

Applying for a permanent impairment benefit

Making a claim for an impairment benefit is an important step, and we recommend that you seek help from us to make this claim. We would take the following steps:

  1. Obtain all relevant treating doctors’ reports.
  2. Complete a claim form for permanent impairment, at least 12 months after your injury date, and lodge it with the WorkCover insurer, together with medical reports.
  3. The WorkCover insurer will send you to a doctor for an assessment.
  4. The insurer receives the doctor’s report and advises you whether you have an entitlement to compensation, and if so, how much.
  5. If you are not happy with the WorkCover decision, you may refer your claim to a Medical Panel.

Common Law (Fault) Claims

  1. A common law claim is a claim made when you can show that fault or “negligence” on the part of your employer or some other person has caused your injury.
  2. A successful common law claim results in a payment of a lump sum called “damages” to you.
  3. You must show you have suffered a “serious injury” to be able to claim damages.

Serious Injury

  1. The process of showing you have a serious injury usually begins with an assessment of your permanent impairment.
  2. If your permanent impairment is 30% or more (this is quite rare), you will automatically qualify with a serious injury.
  3. If your permanent impairment is less than 30%, and you want to claim common law damages, you will need to apply to the WorkCover insurer for a serious injury certificate. This requires:
  • permanent serious impairment or loss of a body function; or
  • permanent serious disfigurement; or
  • permanent severe mental or permanent severe behavioural disturbance or disorder; or
  • loss of a foetus.

If the WorkCover insurer will not grant you a serious injury certificate, we can appeal this decision in the County Court.

Damages

Once you have proved your serious injury, your lawyer must negotiate with the WorkCover insurer for the appropriate payment of damages (money) to you. If negotiations fail, we will go to Court for you.

Damages have two components:

General damages. Paid for pain and suffering and loss of enjoyment of life. If you can show that you have a permanent serious injury, you can claim general damages for pain and suffering, even if you are still working.

Loss of Earnings Damages. You can claim a lump sum for past and future loss of wages if you have a serious injury and you have suffered a permanent 40% loss of earning capacity compared with your pre-injury earning capacity.

Once you receive a lump sum for lost wages, your weekly payments of compensation will stop.

If you receive a lump sum, whether for lost wages or for pain and suffering, you are still entitled to payment of medical benefits.

Rehabilitation

As part of the process of showing you have a serious injury, you must show that you have tried to obtain other work or to involve yourself in a rehabilitation program to maximise your employment opportunities. It is helpful to keep a diary recording these efforts from as early as possible.

Death Benefits

If work has contributed to the death of a worker, the dependants of the deceased Worker can claim these benefits:

  • a lump sum to be divided between a dependent spouse and dependent children;
  • a weekly pension for dependants for three years and in the case of children, to age 16. If a child is a full-time student, the pension will continue so long as the child is a student or until 21, whichever occurs first;
  • family counselling by a doctor or psychologist;
  • reasonable costs of burial or cremation.

If a death has been caused by negligence, the dependants of the Worker may possibly sue for damages. However, because such damages are offset against Death Benefits, claims for common law damages in this circumstance are rare. Legal advice is essential in these circumstances.

Continue reading next...

Understanding WorkCover Claims (VIC)

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