Permanent impairment disputes

This is usually when the worker and insurer have both sought assessment of permanent impairment but the two assessments do not give the same degree of assessed permanent impairment.

When the insurer disputes liability for your claim for lump sum compensation, and/or the level of permanent impairment in relation to a threshold, they will advise you of their reason(s) in writing and provide information on the next steps available to you.

If you have received the decision notice, with supporting reasons provided by the insurer, and you dispute the notice, you can apply to have the dispute resolved in the following ways.

Request a review by the insurer

You may contact the insurer and request they review the decision.

The insurer will advise you of the procedure to request the review and forward you any relevant forms or documents you may need, if they have not already done so.

When requesting the review, you should explain why you are requesting it and include any additional information you think is relevant to help the insurer review the decision.

It is important you include all relevant information now, as you may not be allowed to introduce new material if you later choose to lodge an application to resolve the dispute at the Personal Injury Commission.

The insurer must respond to you in writing within 14 days of receiving the request for a review.

Contact IRO

As a worker, you can contact the Independent Review Office (IRO) if you are dissatisfied at any stage during this process, need assistance or information.

The IRO is an independent statutory office with a variety of roles, including helping find solutions to disputes for injured workers.

The Independent Review Office (IRO) can advise you (the worker) about how to get advice from a lawyer approved under the Independent Legal Assistance and Review Service (ILARS). The lawyer will review your case and may make an application to IRO to see if funding is available to help resolve the dispute in the Personal Injury Commission.

For more information about how IRO can help, you can:

• visit their website,
• call IRO on 13 94 76, or
• send an email to [email protected].

Apply to the Personal Injury Commission

The Personal Injury Commission is an independent tribunal that helps resolve workers compensation disputes between workers and employers/insurers.

If you are not satisfied with the insurer's decision on the assessed degree of permanent impairment as a result of your work-related injury, you can lodge an application to the Personal Injury Commission.

The Personal Injury Commission will refer the dispute to a decision-maker who can either determine the degree of permanent impairment or refer the dispute to a Medical Assessor for an assessment.

Any party to the dispute may appeal the medical assessment certificate based on specific grounds set out in the legislation.

If this occurs a panel will review the medical assessment and make a determination.

For more information visit the Personal Injury Commission website or call 1800 PIC NSW (1800 742 679).