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When does a worker become eligible to claim lump sum compensation?

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Posted on

June 30, 2021

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Workers Compensation
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Workers compensation lump sum payments in NSW

In New South Wales, when a worker sustains an injury during the course of employment, physically or psychologically, he/she can claim compensation for losses arising from the injury. Workers compensation benefits that an injured worker can claim include income support for lost earnings, medical and rehabilitation expenses, and in certain circumstances lump sum payment.

Workers compensation lump sum payment is achievable when the worker’s injury results in a permanent impairment that is assessed being at 11% or greater. For primary psychological injuries and illnesses caused or aggravated by work, permanent impairment should be assessed at 15% or more. A lump sum claim cannot be made for secondary psychological injuries. For exempt workers (police, firefighters, and paramedics) lump sum compensation for physical injuries can be made as long as the injury has given way to some level of permanent impairment greater than 0% whole person impairment. Exempt workers may be entitled to make more than one lump sum claim for their work-related injuries. Other classes of workers can make more than one lump sum claim only if they made a claim for permanent impairment before 19 June 2012 and their condition has deteriorated.
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In New South Wales, when a worker sustains an injury during the course of employment, physically or psychologically, he/she can claim compensation for losses arising from the injury. Workers compensation benefits that an injured worker can claim include income support for lost earnings, medical and rehabilitation expenses, and in certain circumstances lump sum payment.
Workers compensation lump sum payment is achievable when the worker’s injury results in a permanent impairment that is assessed being at 11% or greater. For primary psychological injuries and illnesses caused or aggravated by work, permanent impairment should be assessed at 15% or more. A lump sum claim cannot be made for secondary psychological injuries. For exempt workers (police, firefighters, and paramedics) lump sum compensation for physical injuries can be made as long as the injury has given way to some level of permanent impairment greater than 0% whole person impairment. Exempt workers may be entitled to make more than one lump sum claim for their work-related injuries. Other classes of workers can make more than one lump sum claim only if they made a claim for permanent impairment before 19 June 2012 and their condition has deteriorated.
Assessments for permanent impairment should be carried out by a qualified medical specialist who is trained in the use of the guides and listed on the State Insurance Regulatory Authority (SIRA) website. Workers must go through the maximum medical improvement in order to be eligible for receiving assessment, that is, their condition has stabilised and is unlikely to change within a year or without treatment. SIRA advises those workers who are not unsure whether they reached maximum improvement to consult their doctors or specialists.
Workers can claim lump sum compensation while making a claim for other benefits like weekly payments and medical expenses. Otherwise, they should complete and submit a Permanent Impairment Claim Form that can be found on SIRA’s website. Upon receiving the worker’s claim form, the insurer should either accept or dispute liability within one month. This time frame can be extended if the insurer demands additional information from the worker.
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Other facts about lump sum payment for workers compensation

  • For claims made on or after 19 June 2012, lump sum compensation for pain and suffering is not payable.
  • If a worker sustains both physical and primary psychological injuries in the same accident, the compensation for permanent impairment will be determined based on the greater amount payable.
  • If multiple physical injuries are sustained as a result of the same accident, they will be assessed together for determining the degree of permanent impairment while physical and psychological injuries will be considered separately.
  • When a work accident results in the worker’s death, his/her dependent may be entitled to lump sum compensation in addition to weekly payments and reasonable funeral expenses.

Compensation advice of lump sum payments

The team at Withstand Lawyers is approved by Workcover Independent Review Office (WIRO) and our experienced workers compensation lawyers have assisted thousands of injured workers. We can assist you to get the highest workers compensation lump-sum payment possible on No Win No Fee basis. Our workers compensation Withstand Lawyers is conventionality located in Sydney & Parramatta and we are happy to meet you in Penrith, Liverpool, Northern Beaches, Newcastle, Wollongong by appointment. Please call us on 1800 952 898 or book a consultation online for free compensation advice for lump sum payments and workers compensation claim assistance.

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*Our No Win No Fee policy means that you will not be out of pocket for our costs or disbursements if you lose your claim – no win no fee. If we commence court proceedings and you are unsuccessful you still won’t be out of pocket for our costs and disbursements however you will be out of pocket for the other sides legal costs and disbursements. Prior to commencing proceedings we will provide you with an authority explaining the risks and costs which could arise if you lose in court, one being that if you lose in court you would be liable for the legal costs and disbursements of the other side.

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