Workers Compensation: How are injuries assessed?

Since 1926, all workers in New South Wales have enjoyed the benefit of statutory protection for the purpose of providing, if the worker is injured and unable to work and/or requires medical treatment, benefits to ensure that they are adequately compensated. Regrettably, successive New South Wales Governments have “reformed” the Workers Compensation Scheme. Each reformation has resulted in a reduction in the benefits available to the injured worker and has served to increase the profits of the insurers. Reforms enacted by successive NSW Governments have resulted in what we have today being the most restrictive and limited Workers Compensation Scheme ever enacted.

The Scheme, as it always has, provides for benefits for all and any injuries suffered by a worker, whether they be physical or psychological. Any injury that results in a compromise on the part of the worker to engage in their usual occupation or results in some degree of whole person impairment or requires medical treatment, is capable of being assessed under the Scheme.

The injury is, invariably, initially assessed by a treating doctor. A certificate and/or report is provided detailing the nature of the injury, the causal link between the injury and the employment, the extent of any incapacity for work and treatment required. It is then incumbent upon the insurer to either accept or reject the initial assessment. In the event that the assessment is accepted, the worker will receive benefits under the Workers Compensation Scheme including payment of weekly compensation (wages) for periods of absence from work and payment of all reasonable and necessary medical treatment expenses.

If the initial assessment provided by the treating doctor is rejected by the insurer, the insurer will arrange its own independent medico-legal assessment of the injured worker. If the medico-legal assessor agrees with the initial assessment provided by the treating doctor, then the benefits referred to will be paid by the insurer voluntarily.

If the medico-legal assessor does not agree with the initial assessment and a dispute arises, then the matter will need to be determined through the Workers Compensation Commission. An application can be made to resolve the dispute which will result in the appointment of an approved medical specialist who will determine the issue in dispute, with such determination being binding upon the parties. There are very limited grounds available to appeal the determination of the approved medical specialist.

Accordingly, if you or someone you know has suffered an injury at work, then that injury will be capable of assessment to determine what, if any, benefits may be available to the injured worker. This could include, in addition to weekly benefits and medical expenses, payment of a lump sum commensurate with the degree of impairment resulting from the injury if it is severe enough to reach the necessary threshold imposed under the legislation. Currently, that threshold is greater than 10% whole person impairment.

Brydens Lawyers are the experts in the prosecution of all workers compensation claims. For expert legal advice and representation contact Brydens Lawyers without delay as time limits may apply to some workers compensation claims. For a risk free, no-obligation assessment call Brydens Lawyers on 1800 848 848 or contact us at brydens.com.au Brydens Lawyers – #WEDO workers compensation claims.