How Permanent Impairment is Assessed in WA
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A permanent impairment assessment in WA is a key step in many Workers’ Compensation claims. This process determines the degree of a worker’s impairment resulting from an injury or illness. This guide explains the process for insurers, lawyers, and their clients, emphasising the independence and fairness of these assessments.
What is a Permanent Impairment Assessment?
A permanent impairment assessment is an evaluation of the long-term effects of an injury or illness. Unlike a temporary injury, a permanent impairment is stable and is unlikely to improve. These assessments are required to calculate a lump sum for impairment and are conducted in accordance with the WorkCover WA guidelines.
How Permanent Impairment is Assessed in WA
The assessment process follows a clear, structured path to ensure objectivity and consistency.
- Referral: An insurer or lawyer refers the claimant to an independent medical specialist.
- Medical Review: The specialist reviews the claimant’s medical history, including all relevant reports and clinical notes.
- Clinical Examination: The specialist conducts a thorough examination, which may be physical or psychological, to assess the injury’s impact.
- Impairment Rating: Using the WorkCover WA guidelines, the specialist calculates a percentage of whole person impairment. This is a specific percentage score that represents the degree of functional loss.
- Report Preparation: A comprehensive medicolegal report is prepared, detailing the findings and the calculated impairment rating.
Who Conducts the Assessment?
Assessments are conducted by independent medical specialists who have been approved by WorkCover WA. Their role is to provide an objective medical impairment evaluation without prior knowledge of the claimant. Their independence ensures the integrity of the process and the impartiality of the report. The assessor is not a treating doctor and provides no medical advice or treatment.
What Claimants Should Know
For claimants, undergoing a permanent impairment assessment can feel daunting. Here’s what you should expect:
- The Exam: The specialist will ask you questions about your injury, daily activities, and work capacity. They will also perform a clinical examination. The goal is to understand the full impact of your injury.
- What to Bring: You should bring a valid form of ID and any relevant medical records, x-rays, or test results not already provided.
- The Outcome: The assessment is an impartial process based on established guidelines. Its purpose is to quantify the functional loss from your injury, which is a necessary step for your claim.
How WorkCover WA Guidelines Are Applied
The WorkCover WA guidelines provide a standardised framework for assessing a worker’s impairment. The guidelines use a system to convert specific physical and psychological losses into a percentage of whole person impairment. This ensures that the process is consistent, transparent, and fair, regardless of which specialist conducts the assessment.
How Reports Are Used in Legal Contexts
The medico-legal report is a crucial part of a claim. It is provided to the lawyer or insurer who requested it and is not shared directly with the claimant. The report’s findings, particularly the impairment rating, are used to:
- Calculate a Lump Sum: The impairment rating is used to determine the compensation assessment for a lump sum payment.
- Resolve Disputes: The report can serve as a neutral piece of evidence in cases where the extent of the injury is disputed.
FAQs about Permanent Impairment Assessments
What happens during a permanent impairment assessment in WA?
During the assessment, an independent medical specialist will review your medical history, discuss your injury with you, and conduct a physical or psychological examination to determine the extent of your permanent impairment according to the WorkCover WA guidelines.
Who can request a WorkCover permanent impairment assessment?
A WorkCover permanent impairment assessment can be requested by an employer, an insurer, or a claimant.
How are impairment ratings determined?
Impairment ratings are determined by an approved medical specialist using specific criteria and tables outlined in the WorkCover WA guidelines, based on the findings from their clinical examination and a review of your medical records.
What is whole person impairment?
Whole person impairment is a percentage that reflects the degree of a person’s permanent functional loss as it relates to their entire body. It provides a standardised measure for the severity of the injury.
How long does the assessment process take?
The assessment itself typically takes between 30 and 90 minutes, depending on the complexity of the case. The time for the report to be completed and delivered can vary.
What documents should be provided before the assessment?
All relevant medical records, including specialist reports, clinical notes, and imaging results (like X-rays or MRIs), should be provided to the assessor for review before the appointment.
Are psychological conditions included in permanent impairment assessments?
Yes. In WA, psychological conditions can be included in permanent impairment assessments if they are work-related or accident-related, stable, and assessed by an accredited psychiatrist using the Psychiatric Impairment Rating Scale (PIRS).
Can a claimant challenge or appeal the results?
Yes, if a claimant disagrees with the results of a permanent impairment assessment, they have the right to challenge or appeal the outcome through the appropriate legal channels.
How do PI assessments affect WorkCover claims in WA?
A permanent impairment assessment is a prerequisite for a claimant to receive a lump sum payment for their injury under a WorkCover WA claim.
What is the difference between impairment and disability in legal terms?
Impairment is a medical term that describes the loss of function of a body part or system. Disability is a legal term that refers to the effect of the impairment on a person’s ability to work and participate in society.