Permanent Impairment Benefit

What is a Permanent Impairment Benefit?

A Worker who is injured at work or has an illness caused by work that has resulted in a Permanent Impairment. A worker with a permanent impairment may be eligible for a permanent impairment claim, paid out as a lump sum payment. This is a one-off payment.

The permanent impairment benefit is separate from weekly workcover payments and medical expenses.

It is still part of the no-fault Workcover system.

This benefit is not associated with a Common Law claim but is used to reference a serious injury which is part of the requirement of making a common law claim. If your Permanent Impairment figure (measured in percentage points) is 30% or greater then the injury is then deemed a serious injury.

Examples of a permanent impairment may include:

• Reduced shoulder movement
• A spinal cord injury
• An amputated finger.

A solicitor is not needed to lodge a permanent impairment claim, but you have a right to legal representation if you choose. The Workcover Agent/ Insurance company will then liaise with your legal representative if you choose.

The Permanent Impairment benefit claim is classified as a non-economic loss

Worksafe does not cover your legal fees incurred throughout the Permanent Impairment process.

An impairment benefit is a once-off lump sum payment given to injured workers who have a permanent impairment resulting from a work-related injury or illness.

It can be a permanent Physical or Psychological condition.

How is your impairment assessed?

To be eligible for an impairment benefit, your injury or illness must be assessed once your condition is stable. Usually, 12 months after surgery is deemed stable. Assessments are conducted by doctors called Independent Impairment Assessors that are specially trained in assessing Impairment type injuries and illnesses according to specific guidelines. The Workcover Agent/Insurance company will organise the assessment.

Impairment is measured using the American Medical Association's (AMA) Guidelines.  

The Guides provide specific instructions in medical terms about how to measure the extent that an injury has affected your body movements, systems or functions.

Each injury is given a percentage score, based on the level of impairment. Impairment is measured at a medical examination conducted by an Independent Impairment Assessor (doctor). The doctor is required by law to use the Guides to assess impairment.

All doctors conducting Independent Impairment Assessments (Impairment Assessments) in Victoria must complete training approved by the Victorian Government.

Your Workcover Agent/ Insurance Company, will choose the doctor according to your injury type. If you have more than one work-related injury from the same incident, an injured worker may be asked to attend more than one examination. The Workcover Agent/insurance company will provide the doctor with medical information relating to your injuries. Up to date information may be requested from your treating healthcare practitioners before arranging the assessment

What will happen at the Impairment Assessment?

The doctor will ask a series of questions about the treatment you have received and your current problems.

They may also ask questions that do not directly relate to your injury to better understand your circumstances.

Depending on the nature of your injury, the doctor will conduct a physical examination. This is to measure the effect of each injury or condition on your ability to move or function as normal.

What happens after the Impairment Assessment?

A percentage score describing the level of permanent impairment of your assessed injury. A copy of the report will be sent to your Agent. They should send you a copy.

If you are legally represented, your Agent will liaise with your lawyer about the report.

When all impairment reports have been received and reviewed by your Agent, you will receive a Notice of Impairment Benefit Liability, Assessment and Entitlement explaining:

• whether the Agent accepts liability for each injury you have claimed
• the level of permanent impairment for each injury (if liability is accepted), and
• the amount of your entitlement.

Your Agent has up to 120 days to determine whether you are entitled to an impairment benefit.

If the Impairment Assessor says your injury is not stable, you will need to wait until your injury becomes stable before you can be assessed again.

The timing of future appointments may depend on your treatment plan.

Note: Pain Management and Cortisone injections can influence if the injury is stable for the impairment assessment.

The Notice of Impairment Benefit Liability, Assessment and Entitlement has a Worker's Response Form attached and you must complete your response within 60 days of receiving this Notice.

The Worker's Response Form gives you the option to:

• accept or reject the liability decision regarding each claimed injury
• accept or reject the assessment of your level of impairment
• accept or reject the calculation of your impairment benefit entitlement.

If you accept the liability decision, impairment assessment and calculation of entitlement, the impairment benefit claim can be finalised.

 

Any entitlement will be paid to you by your Agent within 14 days of receiving your signed Worker's Response Form.

 

If you dispute the liability or calculation of entitlement decision

You can take your dispute to the Accident Compensation Conciliation Service (ACCS).

The ACCS is a free service and gives injured workers, employers, and agents the opportunity to resolve disputes with the help of a Conciliation Officer.

If the dispute cannot be resolved at Conciliation, the Conciliation Officer may issue a Certificate of Genuine Dispute which will enable you to start proceedings at Court.

In some instances, the Conciliation Officer may ask the Medical Panel to provide an opinion on a medical question.

 

If you wish to dispute the assessment of your level of impairment,

Your claim will be referred to a Medical Panel for Independent Impairment Assessment within 14 days.

The Medical Panel will advise you when to attend for further assessment and will provide their opinion to your Agent.

The Medical Panel's opinion is binding and is not reviewable by the Accident Compensation Conciliation Service or the Magistrates' Court.

If you want to know more about potential review rights you should seek advice as soon as possible as time limits apply.

You may wish to speak to your union representative, Union Assist, or seek legal advice.

Union Assist is run by the Victorian Trades Hall Council located at 54 Victoria Street Carlton. Ph 93696144. Website www.unionassist.org.au .

If you wish to seek legal advice and do not have a lawyer, you may wish to

contact the Law Institute of Victoria to access their free Legal Referral Service:

• 03 9607 9311 or
• Website liv.asn.au

 

The information on this website produced and distributed by the IWSN is of a general nature. We do our best to ensure the information is accurate and up to date, but cannot take any responsibility for any loss arising out of its use. You should not rely on it applying in your own circumstances and should always take further advice from those with appropriate qualifications.

 

Last updated August 2024.