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Don’t let Workcover close your claim without getting a ‘Notice of Assessment’

For some people, receiving weekly payments from Workcover Queensland following a workplace injury is enough to tide them over until they have fully recovered and returned to work. In this case, Workcover will stop paying the weekly benefit and close the claim – balance is restored – everybody is happy.

But what if despite returning to work, you haven’t “fully” recovered?

Or what if you had to find a new job that is different and less physical than your old one?

If either of the above two scenarios applies to you, you are actually entitled to be assessed by a doctor to determine if your work-related injuries have left you with a degree of permanent impairment (DPI) which is expressed as a percentage.

Pursuant to Section 178 of the Workers’ Compensation and Rehabilitation Act 2003 (‘WCRA’), all injured workers who have an accepted application for compensation are entitled to request an independent medical assessment from WorkCover to decide if they have sustained a permanent impairment from the accepted work-related injury/ies.

An assessment of permanent impairment can only occur once all reasonable treatment and rehabilitation has been provided for the work-related injury and is medically deemed at ‘maximum medical improvement’. Should you be assessed to have sustained a permanent impairment from the injury, you are entitled to receive a lump sum offer of compensation for the permanent impairment.

The assessment is performed by either a specialist doctor or in the case of psychiatric injuries, a panel of three doctors that will form a Medical Assessment Tribunal (‘MAT’). The specialist doctor(s) will be doctors that you haven’t met with before so that an independent medical assessment (‘IME’) can be conducted. The result of an IME is a report addressed to the insurer outlining your ongoing symptoms and calculating your degree of permanent impairment (‘DPI’).

For example, if you have an ankle injury, a specialist orthopaedic or ankle surgeon may assess your injury to cause you a 7% DPI. The doctor’s assessment comes in the form of a report addressed to Workcover and you may not always be provided with a copy. Within 10 business days of Workcover receiving this report, they will issue you with simple letter called a ‘Notice of Assessment‘. In the letter, along with your assessed % of impairment, you will be given a lump sum offer of compensation if you have been assessed as having a 1% DPI or more.

If you have received a Notice of Assessment containing a lump sum offer of compensation it is important to seek legal advice prior to accepting it. If you accept the lump sum offer, the decision cannot be undone.

How to get your Workcover Notice of Assessment

Workcover do not always advise injured persons of their right to be assessed formally for a DPI score and you may have to request this. So long as you have made a statutory workers compensation claim, you are entitled to ask Workcover to be formally assessed to decide if your injury causes you a degree of permanent impairment, and if so, to which degree.

We always recommend that a request to be assessed, whilst very simple, comes from a lawyer on your behalf. This way, Workcover get put on notice that the assessment must take place instead of telling you that ‘the claim is already closed’ which is known to happen despite Section 179 of the WCRA requiring the insurer to organise an assessment if the request is made.

Further, if you fail to ask for the assessment prior to the expiry of 3 years from the date of event causing injury, you may find yourself statute-barred from bringing a common law claim for damages.

Already received your Workcover Notice of Assessment?

Once you have completed your IME and have been provided with a Notice of Assessment, you may feel disappointed with the determined level of impairment. Sometimes, the DPI score may even be 0% and the accompanying letter to you will say that you are not entitled to a lump sum offer of compensation.

Read More: Why a DPI score of 0% might not matter

Regardless of whether your notice of assessment indicates a DPI of 0% or more, our advice is to never accept the offer no matter how good it looks unless you have had legal advice first. Roche Legal provides free advice over the phone in this regard so there is nothing to lose by picking up the phone.

By accepting a lump sum offer in your Notice of Assessment, you effectively agree to not pursue a greater amount of damages in a negligence claim against your employer (often referred to as a ‘common law claim’). This could mean the difference of $100,000’s in your pocket and the decision, once made, cannot be undone.

Read More: Why You Shouldn’t Take The Lump Sum Offer

If you have been assessed by Workcover and received a Notice of Assessment with a lump sum compensation offer, call our office for a free, no obligation assessment of your circumstances.

If you have not been assessed by Workcover for a degree of permanent impairment (DPI), contact us without delay to find out whether you are entitled to be issued with a Notice of Assessment.

Do not delay as strict time limits apply – it is incredibly important to request a Notice of Assessment in a timely manner to prevent becoming statute barred from bringing a common law claim.

This commentary is published by Roche Legal for general information purposes only and should not be relied on as specific advice. The content relates to Queensland law only and is subject to change over time. You should seek legal advice for any question, or for any specific situation or proposal, before making any decision.