Permanent impairment claims

If you have a permanent impairment as a result of a workplace injury or illness, you may be entitled to receive a lump sum payment as compensation. 



This is in addition to weekly payments and medical and related expenses that may generally be available through the workers compensation system.

The information below is general in nature and the payments you receive may vary based on your circumstances.

Eligibility

Payments for lump sum permanent impairment compensation made on or after 19 June 2012, including those for injuries that occurred on and from 1 January 2002, are based on an assessment of your permanent impairment.

A minimum level of permanent impairment must be present before payment can be made.  The minimum level is greater than 10 per cent permanent impairment, except for primary psychiatric and psychological impairments which require a minimum level of 15 per cent permanent impairment.

Note: If you made a claim for permanent impairment before 19 June 2012, you may be entitled to lump sum compensation for injuries assessed below the minimum level. No permanent impairment compensation is available for secondary psychological injuries.

Eligibility for exempt categories of worker

You are an exempt category of worker if you are a police officer, paramedic, fire fighter, volunteer bush fire fighter or emergency services volunteer.

Payments for lump sum compensation to you can be for:

  • permanent impairment sustained as a result of a work related injury or illness
  • pain and suffering arising from the impairment.

There is no minimum level of permanent impairment for exempt categories of workers. 

Lump sum permanent impairment and pain and suffering payments are made in addition to payments and expenses that may generally be available through the workers compensation system.

Assessment of permanent impairment

The impairment must be assessed by a medical specialist listed on our website as a trained assessor of permanent impairment.
 

Your injury must have reached maximum medical improvement. This means the condition has been medically stable for the previous three months and further recovery or deterioration of more than three per cent is not expected in the next 12 months.  

Making a claim

A permanent impairment claim form is required unless your claim for weekly and other benefits has already included a claim for lump sum compensation for permanent impairment. 

The form provides details of the information that must be supplied when making a claim. Only one claim for permanent impairment compensation can be made in respect of the injury. 

Note: If you made a claim for permanent impairment before 19 June 2012, or if you are an exempt worker, you may be entitled to make more than one lump sum compensation claim and you are not required to meet the minimum level of greater than 10 per cent permanent impairment.

The WorkCover guidelines for claiming compensation benefits require the employer to:

  • send the claim to the insurer within seven days of receiving it
  • respond within seven days to requests from the insurer for more information
  • forward any documentation concerning the claim to the insurer within seven days

If the insurer is satisfied with the supporting documentation, it may accept your specialist's assessment and settle the claim for permanent impairment, without needing to obtain additional assessments. 

Complying agreement

A complying agreement is a written agreement between you and the insurer regarding the lump sum payment for permanent impairment and, if eligible, for pain and suffering. 

Prior to making the payment for permanent impairment, the insurer must be satisfied that you have obtained independent legal advice or have waived the right to independent legal advice. 

The insurer is required to record evidence that this advice has been obtained, or that it has not been obtained, and the details of the agreement.

Benefits payable for permanent impairment

The maximum lump sum payment for permanent impairment injuries incurred:

  • between 1 January 2002 and 31 December 2006 is $200,000, with an additional five per cent for permanent impairment of the spine  for injuries on or after 1 January 2006
  • on or after 1 January 2007 the maximum amount is $220,000 (plus an additional five per cent for permanent impairment of the spine).

View detailed information on benefits (payable for permanent impairment and pain and suffering compensation in the Workers compensation benefits guide

Benefits payable for pain and suffering

If you are an exempt worker you may also receive an additional lump sum payment for pain and suffering arising from a permanent impairment if you have 10 per cent or more whole person impairment.

For a primary psychiatric and psychological impairment there is a 15 per cent threshold.
The maximum amount payable is $50,000.

View detailed information on benefits (payable for permanent impairment and pain and suffering compensation in the Workers compensation benefits guide.

WorkCover Independent Review Office

The injured worker is responsible for their own legal costs with regard to their claim for lump sum compensation but the WorkCover Independent Review Office (WIRO) has established the Independent Legal Assistance and Review Service. This service provides access to free independent legal advice to injured workers through the provision of a grant, where there is disagreement with insurers regarding their claim for lump sum compensation for permanent impairment.

You can call the WIRO on 13 94 76 or contact them by email to complaints@wiro.nsw.gov.au.

Fact sheet

The WorkCover Independent Review Office fact sheet contains general information about workers compensation entitlements and procedures. This fact sheet is not a detailed explanation of the law as it applies to claims made by individual workers.