Walker Law Group are pleased to share a video released by WIRO (Workers Compensation Independent Review Office) providing relevant information for workers regarding Section 39 and what you need to know.
We are leading the way for WIRO claims across NSW.
The following video and transcript is from WIRO.NSW.gov.au
This year the government is set to implement one of the biggest changes to your workers compensation benefits. If you’re still receiving weekly payments since just before 1 October 2012 your payments are set to be cut off this year unless you do something about it or unless you can prove that you have been so badly hurt that you may be entitled to continued to payments. It could be as early as September, but what we know so far is there is a large number of you whose weekly payments may be cut off in December on Boxing Day if your payments have reached the 260 week mark.
If you find yourself in this situation do not ignore it. Anytime now your insurer will be sending you a letter (if they haven’t already done so) telling you whether or not your weekly payments should continue beyond 260 weeks.
The tests the insurers appear to be using is no longer whether or not you are fit to return to work but a measurement of your capacity to perform work. There’s a difference they’re looking to see what you can still actually do at work instead of what you can no longer do at work.
Confusing? Here’s what you need to look out for. If you’ve received such a letter from the insurer, the insurance letter would normally tell you how many weeks of payments you’ve already received and how many weeks of payments you have until you reach 260 weeks. The letter should also tell you whether or not you’ve been classified as a badly injured worker and what they’re doing to make that decision.
If you’re badly hurt, because the insurer decides you have a degree of permanent payment of at least 21% whole-person impairment or WPI then you will continue to receive weekly payments and you will not be cut off. If you’re not classified as badly hurt meaning you have a degree of permanent permit of 20% or less WPI and there’s a possibility that your weekly payments will be cut off once you’ve reached the 260 week mark 21% WPI is a very high standard and is quite hard to reach but it’s the only evidence you need so that you can be classified as a badly hurt so don’t ignore it
The insurer will write to you and tell you they’ve arranged (or will arrange) for their doctor to medically examine you so they can find out. If you’re a badly hurt worker the doctor will provide the insurer with a medical report telling them what your percentage WP is, but remember, this is only their doctors medical opinion and you must understand it’s not final. You are entitled to obtain a second medical opinion from your own doctor.
Consider these points:-
If the insurance doctor says that you are not fatally hurt (meaning your weekly payments may be cut off). You can disagree with that doctors medical opinion you should go and see a lawyer so they can provide you with legal advice and assist you in getting your own medical evidence. Don’t worry about the cost of a lawyer, because the WIRO assists injured workers by providing legal aid funding to lawyers.
Walker Law Group will then obtain legal funding from WIRO so that they can help you in obtaining your own doctor’s medical assessment report and dispute some insurers decision to potentially cut off your weekly payments after the 260 week mark.
You must see your lawyer quickly because it will take a little bit of time to find a suitable doctor to undergo your own medical examination and for your doctor to provide you and your lawyer with a medical assessment report. If your own doctors medical assessment report can prove you are a badly hurt worker (meaning you have at least 21% WPI) you can then use it as your medical evidence to dispute the insurance decision.
You may not know it but apart from this potential problem there are other complications that may apply in your situation because of the changes in the law in 2012. The changes now mean you are limited to only one medical assessment certificate for the same claim What this means is that the report is your one and only evidence that you can rely on if you decide to make a lump sum compensation claim. This is different to the entitlement for weekly compensation.
Now this is where it becomes tricky if you’re getting a second medical opinion about your degree of impairment it can be costly and it can be difficult especially if you’re doing it yourself. What can you do if you’ve had a previous medical report? did you receive a Medical Assessment Certificate or a MAC from the Workers Compensation Commission? Can you still obtain and rely on your doctor’s current medical assessment report to prove that you’re a badly hurt worker and still make a claim for lump sum compensation since your last medical assessment?
All this is very tricky which is why you need to see a lawyer. It’s important that you tell your lawyer everything that has to do with your injury bring with you the letter you’ve received from the insurer and any medical report they have given you especially if you’re confused about all this technical and medical stuff.
You don’t have to worry about being slugged with legal costs and doctors fees because your lawyer will deal with those costs and WIRO will usually pay for them on your behalf.
Our advice if you’re one of these workers – don’t ignore it! Remember you are entitled to get your own evidence and to dispute the insurance decision to cut off your payments you are entitled to. Get your own legal advice about your benefits you have the right to exercise your options and the right to get that legal advice. It’s happening this year.