Returning to work is the outcome you, your employer and doctor work towards. In some cases, you may be left with a permanent impairment or incapacity for work which entitles you to a lump sum payment to finalise your workers’ compensation claim.
There are different pathways and rules for settling workers’ compensation claims depending on whether the settlement relates to a statutory compensation claim or a common law action.
In order to access certain benefits or settlements, or pursue common law damages, it may be necessary for you to obtain an impairment assessment from an approved medical specialist.
Before making a decision on any option you should seek independent legal advice or contact Advice and Assistance on 1300 794 744 for more information.Impairment assessment
- a claim for damages at common law
- exceptional circumstances medical payments
- a Schedule 2 payment (a lump sum entitlement for permanent impairment).
Note: Other conditions for eligibility apply to each of these entitlements.What is an approved medical specialist?
Only medical practitioners registered by WorkCover WA as approved medical specialists (AMS) can undertake impairment assessments. An AMS is trained to evaluate impairment using the WorkCover WA Guides for the Evaluation of Permanent Impairment and the American Medical Association’s Guides to the Evaluation of Permanent Impairment, fifth edition.
See the getting an assessment section for more details on selecting an AMS and obtaining an assessment.
To obtain an assessment:
As part of managing your workers’ compensation claim, your employer’s insurer may arrange for you to be reviewed by an AMS. Should you wish to arrange an assessment by an AMS of your choice, follow the steps below.
- Access the register of approved medical specialists or contact Advice and Assistance on 1300 794 744.
- Select an approved medical specialist (AMS) from the list. It is advisable to contact the AMS to check their availability and suitability to assess the impairment.
- Formally request an assessment by completing the Form AMS 1: Request for Assessment by Approved Medical Specialist of a Workers’ Degree of Permanent Impairment available from the Workers forms page.
- Provide the Form AMS 1 and any further information that may be requested to the AMS.
- Attend the AMS for assessment at the time, date and place as previously arranged.
- Receive their written report and a certificate of assessment (Form AMS 7 and 8 if your condition has not stabilised – see Condition not stabilised) and/or Form AMS 5 and 6 if your condition has stabilised.
An AMS may require you to attend at a specified place, to submit to an examination and to answer any question about the injury.
The AMS may also require you, the employer or the employer’s insurer to produce any relevant document or information. Time limits may apply for meeting these requirements, and penalties exist for non-compliance.
If your condition has not stabilised sufficiently for the permanent impairment evaluation to be made you may be able to obtain a special evaluation. This can happen if 18 months has passed since you made the compensation claim on your employer.
If the approved medical specialist (AMS) finds your condition has not stabilised to the extent required for an evaluation of your degree of permanent impairment, the AMS is required to give you and your employer a written report and certificate with reasons justifying their findings.
If your injury or illness has resulted in a permanent whole person impairment of at least 15%, you may be eligible to pursue a common law claim against your employer through the court system.
See the Common law claims section for more information on eligibility to pursue common law damages.
For common law access
If liability for your worker’s compensation claim has been accepted, you can claim back from the insurer the cost of the first assessment undertaken for the purposes of common law. This includes any attempt at an assessment that results in a finding that your condition has not stabilised.
For all other entitlements
It is the responsibility of the person requesting the assessment to pay the approved medical specialists’ fees.
In some situations, if an employer or their insurer disputes your level of impairment as assessed by an approved medical specialist, you may be able to lodge an application to resolve the dispute with the Workers’ Compensation Conciliation Service. See the Resolving a dispute section for more details.