Getting a lump sum payout through NSW workers compensation

If you have suffered a physical or psychological injury, or an illness, related to your work in New South Wales, you may be eligible for workers compensation.

Work-related injuries can include back, neck and shoulder injuries; broken bones from slips and falls; skin cancers; and mental illnesses like post-traumatic stress disorder, depression and anxiety.

Workers compensation can cover weekly payments for lost wages, medical expenses and other expenses like travel, ambulance and treatment costs. 

However, you might also be eligible for lump sum payouts for permanent impairment and work injury damages.

However, you might also be eligible for lump sum payouts for permanent impairment and work injury damages.

The eligibility criteria for these lump sum payments is quite strict and can be complex. We strongly advise getting legal advice to find out what you’re entitled to and how to start the claims process.

At Main Lawyers, our experienced workers compensation lawyers can help you determine what you may be eligible for. Read below for more details about how to access these payments.

 

Types of lump sum payouts

Your eligibility for a workers compensation lump sum payout depends on the extent of your injury and whether your employer was negligent in their duty of care for you.

It also depends on the date of your workplace injury, as the legislation has changed over time, so the date determines which legislation applies.

Some exempt workers can’t apply for these types of lump sum payments, including police officers, ambulance officers and fire fighters.

There are two types of lump sum claims for workplace injury:

  • permanent impairment – to cover permanent damage as the result of a work-related injury or illness
  • work injury damages – a common law claim for damages if your injury was caused by your employer’s negligence.

You can receive these on top of other workers compensation payments you may be eligible for, such as payments for medical expenses or pain and suffering.

Note: In New South Wales, you can’t claim workers compensation for pain and suffering payouts. However, the permanent impairment payout is compensation for the overall effect that your work injury has had on your life.

Permanent impairment

This is a lump sum payment for a serious work-related injury or illness.

To be eligible, you must meet certain thresholds for ‘whole person impairment’ – the scale that doctors use to measure the permanent damage an accident has caused.

To be eligible for a permanent impairment payout, you must have either:

  • 11% or more permanent impairment for a physical injury
  • 15% or more permanent impairment for a primary psychological injury.

There is no permanent impairment compensation for secondary psychological injury – such as depression or anxiety brought on by a primary injury.

Work injury damages

This type of lump sum payment is compensation for economic loss due to a work-related injury. It can cover past and future income loss and superannuation.

To successfully claim a payment for work injury damages, you must prove that:

  • your employer had a duty of care to keep you safe
  • your employer breached that duty of care
  • your injury was directly caused by the breach – it was the result of employer negligence.

To be eligible, you must have at least 15% permanent impairment (either accepted by the insurer or determined by the Workers Compensation Commission).

Additionally, you can’t receive this lump sum until you have received all the payouts for permanent impairment that you are entitled to.

To claim for work injury damages in New South Wales, you need to provide details about:

  • your injury and impairment, including when it occurred
  • any previous injury or condition that could have caused it, and any compensation you received for this injury or condition
  • any previous employment that could have caused the injury
  • how your employer breached their duty of care towards you
  • how much you are claiming as damages, with supporting documents.

You also need to provide a report from a permanent impairment assessor.

Be aware that, once you have claimed work injury damages, you are no longer eligible for other workers compensation benefits for that injury, such as weekly payments and medical expenses.  Additionally, any weekly payments you have already received may need to come out of the settlement amount.

All of this can be complex and difficult to navigate. We recommend talking to a workers compensation lawyer so you understand all your options. At Main Lawyers, we can meet with you for a no-obligation discussion about your situation and determine what you may be eligible for.

 

 

How much you can receive

You can make a claim for both permanent impairment and work injury damages if you’re eligible for both. Once you have been assessed, you can make two lump sum claims.

The amount you can receive is calculated based on a scale. Various whole person impairment percentages have different payout amounts – the higher the percentage, the more you can receive. This can range from around $24,000 to more than half a million dollars.

Assessing your permanent impairment

First your level of permanent impairment must be assessed by an independent and qualified medical specialist. Your doctor or surgeon can’t do this assessment.

At the time of your assessment, your injury must have reached ‘maximum medical improvement’. This means your condition is stable and unlikely to change in the next year with or without treatment. Your doctor or specialist can tell you if you have reached this point.

At Main Lawyers, we can organise this assessment for you and tell you whether you can make a lump sum compensation claim. We can even apply to the Independent Review Office (IRO) for funding to cover assessment and other related costs, so you won’t have to pay for it.

IRO also provides funding for our legal fees, so you won’t have to pay for us to investigate or help you with your claim for lump sum compensation.

 

Process timeframe

Timeframe for insurers

We will help you complete your claim for one or both lump sum payouts for workers compensation and submit them to the insurer.

The insurer then has one month to accept the liability and either make a reasonable settlement offer or dispute the liability.

If the insurer needs more information to assess your claim, they will request it from you. This could extend the assessment timeframe. Within two weeks of receiving your claim, the insurer needs to ask you for that information or arrange for a permanent impairment assessor to examine you.

Once the insurer gets the information they need, they have two months to make a settlement offer or reject your claim.

Complying agreement/making a settlement offer

A complying agreement is a written agreement between you and the insurer about your level of permanent impairment, as a result of the assessment.

Before you make the agreement, the insurer will ensure that you have either obtained legal advice or waived your right to legal advice. (It’s always better to get legal advice!)

Mediation and court proceedings

Generally you won’t need to go to court as part of a claim for workers compensation. However, if you disagree with the insurer’s settlement offer, you could decide to go to mediation or start court proceedings.

We can discuss your options with you and help challenge the insurer’s offer through mediation or court if necessary.

Usually you will need to attempt mediation through the Workers Compensation Commission before you can start court proceedings. The Commission will work with all the parties to try to reach a settlement through discussion. Claims often get resolved at this mediation stage and there is no need to go to court.

To start mediation or court proceedings for work injury damages, you need to serve your employer or insurer with the details of the claim and the evidence to support your claim.

You have three years from the date of your injury to start court proceedings for work injury damages, unless you have the court’s approval.

Going back to work

Getting a lump sum workers compensation payout for permanent impairment or work injury damages does not mean you can’t go back to work. In fact, you can return to work when you are physically and mentally able to.

Your workers compensation settlement doesn’t stop you from working in future and should never change how you are treated once you return to work.

Need more help?

Workers compensation is a complicated area of law. That’s why, at Main Lawyers, we give you access to highly experienced workers compensation lawyers who will work through your options and help you get what you’re entitled to.

We also have a strong track record of success and will work hard to get your case resolved as soon as possible – usually without going to court.

And if you can’t come to our office, we are happy to visit you at home, in hospital or any other premises in the Northern Rivers region. Contact us for a free, no-obligation discussion.

For more information about workers compensation, read the New South Wales Government’s Workers Compensation Guidelines.

 

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