How your Statutory Workers Compensation claim is evaluated

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When you are injured at work or become sick due to your work, you are entitled to make a workers’ compensation claim. In Western Australia, under the Workers’ Compensation and Injury Management Act 1981, workers’ compensation is a mandatory and legal insurance scheme that offers medical and financial assistance in the event that you suffer a work-related injury or illness, regardless if you need time off from work or not. All workers – full-time, part-time, and casual – employed in Western Australia are covered by this Act and will still apply even if the injury happened outside of the State as long as the employer’s business has a connection to the State. This law provides you peace of mind that you are always protected.

UNDERSTANDING THE STATUTORY SYSTEM

When you make a statutory workers’ compensation claim, you need to be aware that the statutory system is a capped system. Essentially there are three maximum prescribed amounts for the following as contained in the Indexation of Workers’ Compensation Payments 2020-2021:

Wages and Schedule 2 lump sum payments – $235,971.00
Medical treatment costs including hospital, dental, chiropractic, physiotherapy, psychological etc – $70,791.00
Vocational rehabilitation – $16,518.00

Peninsula Personal Injury Lawyers will assist you in managing and assessing your claim and ensuring that you maximise your financial entitlements under the law.

IMPAIRMENT AND WAGES

There will come a time when the insurer may seek your consent to cease or reduce your weekly payments on the basis that you have demonstrated a capacity for your pre-injury employment or of an alternative role. If this occurs you must seek legal advice. We will assist you by protecting your interests and preserving your workers compensation payments until the time is right to negotiate a lump sum payment of your wages by way of a redemption.

We will arrange for you to be medically assessed by an Approved Medical Specialist, a doctor who is trained and certified to make impairment assessments for the purpose of the Act. This will allow us to give you advice as to the amount of your Schedule 2 lump sum entitlement by virtue of the percentage impairment you have been left with as a result of the work injury.

Both the redemption and the Schedule 2 lump sum payments are limited by the statutory maximum prescribed amount for wages so it is important that you seek legal advice early on to ensure there are sufficient funds left in the prescribed amount.

The Schedule 2 assessment is a lump sum payment made to you based on whatever the percentage value of the prescribed amount of the particular part of the body injured is.

To illustrate how a schedule 2 lump sum and a wages redemption settlement is formulated:

If at the time of your settlement you have already received $100,000.00 gross by way of weekly compensation payments, and your Schedule 2 has been assessed at say $32,000.00, then there is approximately $100,000.00 gross or approximately $70,000.00 net left in the prescribed amount.

We can assist in negotiation a lump sum redemption to determine how much of the net value of the remainder you can receive as a lump sum to settle your claim (in addition to the Schedule 2 payment). It is important to have supporting medical evidence to maximise this entitlement which we will obtain on your behalf.

FUTURE MEDICAL TREATMENT AND REHABILITATION COSTS

The Approved Medical Specialist will also assess any future treatment you will need and provide costings. We will claim these costs in addition to the Schedule 2 and redemption of wages. We will negotiate with the insurer for you and present the best evidence to support your case.

To simply rely on the medical evidence provided by the insurer is not advisable as usually the assessments are modest and questions regarding future medical and vocational rehabilitation costs are often not sought.

Peninsula Personal Injury Lawyers will negotiate with all relevant medical and other evidence obtained to support your claim.

And while statutory claims are capped, Peninsula Personal Injury Lawyers always look after your best interests, making sure that we negotiate tirelessly to obtain the compensation that you need and deserve to move forward in your life.