Relevant Details
- Age group: 50-55
- Injuries: Lumbar spine, Psychological
- Occupation: Labourer
- Key issues: Commutation Eligibility
Background
The claim relates to a workplace injury resulting in a severe lumbar spine injury sustained whilst working as a factory labourer. The injury caused the claimant significant disability and an ongoing incapacity for work. The commutation process was conducted under the Workers Compensation Act 1987, with the State Insurance Regulatory Authority certifying that the injury was not catastrophic and that the requirements for commutation were met.
In the early 2000’s, during employment as a factory labourer, the claimant suffered a lower back injury when performing an awkward cleaning task inside a confined space as directed by the employer. It was a slip and fall incident that caused severe damage to the claimant’s lumbar spine. The claimant was unaware of any NSW workers compensation entitlements and therefore did not lodge a claim until many months after the injury event when a friend suggested they do so.
Shortly after the injury event, the employer terminated the claimant’s employment because they were unable to continue working as a factory labourer. The employer was aware of the claimant’s work-related injury but did not notify the workers’ compensation insurer or advise the claimant to lodge a claim.
Claims Process
- The claimant suffered through pain and discomfort for months before they attended a General Practitioner (GP) and obtained a medical certificate which supported that the lower back injury was sustained at work.
- A NSW workers compensation claim was lodged and after the insurer conducted a thorough investigation into the injury event and the employer’s actions, the claim was accepted. The claimant then received weekly wage payments and their medical and treatment related costs were paid for by the insurer.
- With the appropriate treatment, including a lumbar spine surgery, the claimant eventually reached the point of medical stability but was left with a significant permanent impairment exceeding 20%.
- Because the injury was sustained prior to 2012, the claimant received two lump sum payments for permanent impairment pursuant to section 66 of the Workers Compensation Act 1987.
- The claimant remained on claim for 15 years but eventually the workers compensation insurer suggested a commutation.
- We assisted the claimant throughout the commutation process by gathering medical evidence, obtaining a State Insurance Regulatory Agency (“SIRA”) commutation certificate, and submitting an application for commutation to the Personal Injury Commission for approval.
- The commutation was only permissible after confirming the injury was not a catastrophic injury and all statutory requirements were satisfied.
The Result
The Personal Injury Commission was satisfied the commutation eligibility criteria had been met and the proposed commutation amount was reasonable. Practically speaking, the claimant ‘bought out’ their future workers compensation entitlements (i.e. weekly wages, medical treatment and rehabilitation entitlements) in exchange for a substantial lump sum payment.
This outcome meant that the claimant did not have to attend the GP every month for an updated certificate of capacity; did not have to seek funding approval from their claim handler; or did not have to rely on the insurer to process their wage payment each week.
This information is provided as a practical case study only. The outcome of each case depends on its own merits and the legislation that applies at the time.
