- Workers Compensation Act 1987
- Workplace Injury Management and Workers Compensation Act 1998
- Workers' Compensation (Dust Diseases) Act 1942
- Workers Compensation (Bush Fire, Emergency and Rescue Services) Act 1987
- Workers Compensation Regulation 2016
- Workers Compensation (Dust Diseases) Regulation 2018
- Workers Compensation (Bush Fire, Emergency and Rescue Services) Regulation 2017
- Workers compensation guidelines
- NSW workers compensation guidelines for the evaluation of permanent impairment
- Workers compensation medical dispute assessment guidelines
- Guidelines for workplace return to work programs
- Workers compensation market practice and premiums guidelines
- Guidelines for the approval of treating allied health practitioners 2016 No 2
- Workers compensation licensed insurer business plan guidelines
Standards of practice
- Overarching claims management principles
- Standard of practice principles
- S1. Worker consent
- S2. Worker access to personal information
- S3. Initial liability decisions – general, provisional, reasonable excuse or full liability
- S4. Liability for medical or related treatment
- S5. Recurrence or aggravation of a previous workplace injury
- S6. Recoveries
- S7. Interim pre-injury average weekly earnings calculation
- S8. Insurer making weekly payments
- S9. Reduction in payments of compensation
- S10. Payment of invoices and reimbursements
- S11. Changes in capacity
- S12. Injury management plans
- S13. Additional or consequential medical conditions
- S14. Referral to an injury management consultant
- S15. Approval and payment of medical, hospital and rehabilitation services
- S16. Case conferencing
- S17. Section 39 Notification
- S18. Retiring age notification
- S19. Section 59A notification
- S20. Permanent impairment assessment reports
- S21. Negotiation on degree of permanent impairment
- S22. Insurer participation in disputes and mediations
- S23. Recovery of overpayments due to insurer error
- S24. Factual investigations
- S25. Surveillance
- S26. Arrangement for payments to Medicare Australia
- S27. Notification and recovery of Centrelink benefits from lump sum payments
- S28. Interpreter services
- S29. Cross-border provisions
- S30. Closing a claim
- S31. Death claims
- S32. Managing claims during the COVID-19 pandemic
- Workers compensation benefits guide
- Fees and rates orders
- Standards of practice
S20. Permanent impairment assessment reports
Permanent impairment can be an integral and important component of a worker’s entitlements. Accordingly, permanent impairment assessment reports should be objectively reviewed for accuracy and consistency with claim records.
Permanent impairment assessment reports will be objectively evaluated to ensure correct and consistent assessment for the determination of entitlements.
|S20.1||Insurers are to objectively consider any report on the assessment of permanent impairment to determine whether the assessment is consistent with the information in the claim file and consistent with the NSW workers compensation guidelines for the evaluation of permanent impairment (Permanent Impairment Guidelines).|
Within 10 working days from receipt of the report
|S20.2||If an insurer determines that further information is required in the report or that a report is not consistent with the Permanent impairment guidelines, the insurer is to request clarification or amendment from the assessor.|
Request made within 10 working days after determining that further information is required or that the report is not consistent with Guidelines
Permanent impairment assessment reports must be objectively reviewed for accuracy and consistency with claim records.
This report is referred to in the legislation (section 73 of the 1987 Act) as a permanent impairment medical certificate.
A report of the assessment of permanent impairment may be obtained by the worker or insurer to certify that the worker has received a work-related injury resulting in permanent impairment, and the degree of permanent impairment resulting from the work-related injury.
The medical assessor must have successfully completed requisite training in using the NSW workers compensation guidelines for the evaluation of permanent impairment (that is in effect at the time of the assessment) for each body system they assess. These trained assessors are listed on the SIRA website.
A report of the assessment of permanent impairment may be used to:
- claim non-economic loss compensation
- provide evidence of reaching or surpassing a threshold to be entitled to certain ongoing or extended compensation
- claim damages, or
- seek to commute liability for a claim.
The permanent impairment assessment should contain factual information based on medical information and investigations, as well as the assessor’s history-taking and clinical examination. Other medical information, reports or investigations that are reviewed by the assessor must be referenced in the report. These facts should be thoroughly checked by the insurer.
Note: There are three permanent impairment methods of assessment:
- assessment under the 1926 Act, using the Table of Maims
- assessment under the 1987 Act, using the Table of Disabilities, which applies to injuries received from 4:00 pm on 30 June 1987 to 31 December 2001, and
- assessment under the 1998 Act, using AMA 5 as modified by the NSW workers compensation guidelines for the evaluation of permanent impairment, which applies to injuries received on or after 1 January 2002.
The assessment under each method differs and there are different entitlements attached to each assessment. This Standard primarily addresses assessments of injuries received on or after 1 January 2002.