Workers Compensation Injury Claims

Workers Compensation weekly benefits have been cut off?

If you have been told that your workers compensation weekly benefits have been cut off, then contact Walker Law Group immediately! We pride ourselves on being legal experts in the areas of workers compensation and personal injury. Our solicitors are accredited specialists, which means that the Law Society has recognized that they possess great knowledge and experience in these areas. We have fought against giant insurance groups and can use this experience to give you the best chance of having your weekly payments maintained or reinstated. With over 20 years experience in these practice areas, we can confidently say that we know how insurance companies assess your claim. If you have been contacted regarding your weekly benefits being cut off, then you must act now and contact Walker Law Group Compensation Lawyers to ensure that the information you have been provided is accurate.

Section 39 of the Workers Compensation Act 1987 (NSW)

Section 39 of the above act addresses the cessation of weekly payments for workers compensation claims after 5 years. The section states that a worker is not entitled to any further weekly payment after an aggregate period of 260 weeks in which weekly payments have been made have passed. It does not matter whether or not these 260 weeks are consecutive. This section does not apply if the injured worker in question has an injury, which equates to a permanent impairment of more than 20%. As per section 65 of the Act, an approved medical specialist assesses this degree of impairment through a medical assessment. However, even if a worker does have a permanent impairment of more than 20% they would need to qualify for continuing payment under section 38 of the Act.

In recent months, the ICNSW (icare) Scheme Agents have been contacting injured workers who may have reached this 260 week threshold and have advised them that they must be assessed to determine whether or not they meet the 20% degree of permanent impairment that may make them eligible for further payments.

A brochure containing misleading information is being sent to the injured workers. This brochure advised the injured workers that their weekly payments would be stopped unless they visit the nominated specialist to have their degree of impairment assessed. Along with the fact that this brochure is misleading, it also fails to provide vital information about the “one assessment” barrier, which applies in these cases.

Workplace Injury Management and Workers Compensation Act 1998 (NSW)

This abovementioned “one assessment” barrier is outlined in section 322A of the Workplace Injury Management and Workers Compensation Act 1998 (NSW). This section states that there can only be one assessment made of the degree of permanent impairment of an injured worker. It also states that the medical assessment certificate that is provided following this assessment is the only medical assessment certificate that will be considered in relation to any further medical disputes regarding the degree of permanent impairment that occurred as a result of the injury suffered by the worker. Therefore, a medical dispute in relation to permanent impairment of an injured worker can only be assessed once and cannot be referred for any further assessment if a medical assessment certificate has already been provided.

Although a medical assessment certificate can only be issued once, section 327 of the Act allows a party to appeal a medical assessment. Certain criteria must be met in order to make an appeal. The grounds of appeal include:

  1. Deterioration of the worker’s condition resulting in an increased degree of permanent impairment; or
  2. The introduction of new, relevant information that was not reasonably available at the time of the first medical assessment; or
  3. The assessment is proven to have been based on incorrect criteria; or
  4. The medical assessment certificate contains a demonstrable error.

If your situation matches one or more of the above criteria, then you have grounds to appeal your medical assessment certificate. An appeal is made by application to the Registrar. Time limits do apply for applications to appeal. For example, if you are appealing on the basis of c) or d) above, you must make an appeal within 28 days of the medical assessment. Medical assessments that have been the basis of a determination under section 66A of the Workers Compensation Act 1987 (NSW) cannot be appealed at all, so it important that you make an application to appeal before a determination is made. Due to these time limits and the limitation presented by section 322A of the Workplace Injury Management and Workers Compensation Act 1998 (NSW), it is crucial that you contact one of the specialised lawyers at Walker Law Group as soon as possible.

What you need to know

It is important for injured workers to understand their rights when it comes to making a workers compensation claim. Injured workers should seek independent legal advice to find out more about the assessment process for permanent impairment.

In order to understand your legal rights, you should contact Walker Law Group. It is important to get the right advice, the first time you need it because in many situations, you will only have one chance to make a claim. You only have one opportunity to have your degree of permanent impairment assessed so deciding to do this is not a decision to take lightly. The results of your assessment may potentially mean the end of your workers compensation payments. That is why it is imperative that you contact Walker Law Group to learn about the process of having an assessment made. The compensation lawyers at Walker Law Group are passionate about providing legal advice for workers compensation matters. Contact us now to arrange a consultation on 1300 363 013 or email us at enquiry@walkerlawgroup.com.au.