Here, we make sense of Section 58 of the Return to Work Act 2014.
Lump sum payments under Section 58 of the Act are for permanent impairment caused by a physical injury ie. not psychological injury. These payments are designed to compensate a worker for non-economic loss which is akin to “pain and suffering”.
If you have suffered a physical injury at work and you have an accepted claim, you may be entitled to receive a lump sum compensation. Importantly, it does not matter whether your entitlements to income maintenance and medical expenses ceased some time ago.
The first step is to work out whether your condition has reached maximum medical improvement (“MMI”). This is determined by your treating specialist or general practitioner. MMI is when your condition has been medically stable for the previous three months and is unlikely to change in the foreseeable future (other than temporary fluctuations), with or without further medical treatment.
Once evidence of MMI has been obtained you can ask your claims manager to make arrangements for a permanent impairment assessment. They will then begin the process and likely review your file and draft a report request letter to the nominated assessor. However, it is highly recommended that you seek legal representation to maximise your entitlements.
As you are only entitled to one permanent impairment assessment per claim, it is very important that this process is done properly and all possible related injuries are assessed.
Fortunately, you are entitled to elect the assessor but if you do not elect an assessor, the claims agent will do so on your behalf. We routinely make recommendations to our clients about which specialist to elect based on your circumstances. It is very important to elect an assessor who is competent, thorough and well-versed in dealing with the type of injuries you have sustained to get the best possible assessment.
Following the permanent impairment assessment, the relevant assessor will rate your level of Whole Person Impairment (“WPI”). The minimum threshold to be eligible to receive a lump sum is 5% (“WPI”).
Your entitlement to lump sum compensation will simply depend on your level of WPI and the year of injury. As an example, for injuries which occurred in 2015, the monetary amounts range from $12,051 (based on 5% WPI) through to $482,014 (based on 50% WPI or above). You can access the scale of entitlements in the Schedule of Sums publication on the Return to Work SA website – https://www.rtwsa.com/.
In the case that you have suffered severe injuries and are assessed as having a WPI of 30% or more, you are likely to be deemed a “seriously injured worker”. This would entitle you to income support until retirement age and medical treatment and support services over the course of your lifetime.
For those workers who have not yet undergone a permanent impairment assessment, it is critical that the process is done properly to maximise your chances of being deemed a seriously injured worker.