Permanent impairment

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 Permanent Impairment Assessor (APIA).

Before making a decision on any option you should seek independent legal advice or contact our Advice and Assistance Service on 1300 794 744 for more information.

Impairment assessment

An assessment of degree of permanent impairment or permanent whole person impairment (PWPI) by an APIA may be necessary where you are seeking to access:

  • a claim for damages at common law
  • an increase for special expenses in the medical and health expenses general limit amount
  • permanent impairment compensation (a lump sum amount for permanent impairment).

Note: Other conditions for eligibility apply to each of these entitlements.

What is an APIA?

Only medical practitioners registered by WorkCover WA as APIA can undertake impairment assessments. An APIA is trained to evaluate impairment using the Permanent Impairment Guidelines 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 APIA and obtaining an assessment.

Getting 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 APIA. Should you wish to arrange an assessment by an APIA of your choice, follow the steps below.

  1. Access the register of approved permanent impairment assessors or contact our Advice and Assistance Service on 1300 794 744.
  2. Select an APIA from the list. It is advisable to contact the APIA to check their availability and suitability to assess the impairment.
  3. Formally request an assessment by completing the Form APIA2: Permanent Impairment Assessment – request.
  4. Provide the Form APIA 2 and any further information that may be requested to the APIA.
  5. Attend the APIA for assessment at the time, date and place specified in the notice you will receive from the APIA.
  6. Receive the APIA’s written report and certificate of assessment Form APIA1: Permanent Impairment Assessment – report and certificate if your condition has stabilised and / or APIA6 – Form APIA6: Permanent Impairment Assessment – condition not stabilised notice if your condition has not stabilised – see Condition not stabilised.

Your obligations

An APIA may require you to attend at a specified place, to submit to an examination and to answer any question about the injury.

The APIA 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.

Condition not stabilised

If your condition has not stabilised sufficiently for the permanent impairment evaluation to be made there are certain circumstances in which a ‘special evaluation’ of your degree of impairment may still be made.  These circumstances include where 18 months has passed since you made the compensation claim on your employer.

If the APIA finds your condition has not stabilised to the extent required for an evaluation of your degree of permanent impairment, they are required to give you and your employer a written report and certificate with reasons justifying their findings.

Common law claims

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.

Payment for approved permanent impairment assessors

Your first assessment

Your employer is required to pay for your first impairment assessment if you request an impairment assessment for the purposes of:

  • a claim for damages at common law
  • an increase for special expenses in the medical and health expenses general limit amount
  • permanent impairment compensation (a lump sum amount for permanent impairment).

This includes the costs of a subsequent impairment assessment if the initial assessment found your condition had not stabilised enough for an assessment to be made.

Any additional impairment assessments must be paid for by you.

Resolving a dispute

In some situations, if an employer or their insurer disputes your level of impairment as assessed by an APIA, 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.