I Don’t Want To Close My Claim

Dr David Colvin workers compensation

04/01/2019 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

All workers’ compensation claims are ultimately finalized.  Many patients are apprehensive about this process and some patients express a desire to keep their claim open indefinitely.  Unfortunately, that is not practical or feasible.  If the insurer was obliged to keep all claims open indefinitely, they would not have a viable business and we would therefore not have a workers’ compensation scheme.  Insurers are entitled to close claims and it is legislated that they have that right.

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 claim (see my blog “What is a common law claim?”).

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In order to access a settlement, or pursue common law damages, you will undergo an impairment assessment. This examination is done by specialists, such as myself, who have undertaken further qualifications to become an approved medical specialist (AMS).  The assessment is undertaken using a rigid set of guidelines so that any two medical practitioners should come up with an identical assessment.  That assessment is expressed as a percentage whole person impairment.  This figure is used in determining a financial settlement for your claim.  For most patients, the settlement is in the order of thousands of dollars, very rarely tens of thousands of dollars. The settlement is an acknowledgement by the insurer that you have not have made a full recovery and that you are permanently impaired to some degree. 

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It comes as a surprise to all patients that the assessment makes no allowance for pain. Pain perception is a very individual thing. It is impossible to quantify the impairment from pain, and therefore it is excluded from the assessment. The assessments are based on such things as what operation has been performed, what is the joint range of movement, is the joint stable, is there arthritis as a result of the injury, etc. The assessment also allows for exclusion of conditions that are pre-existing, such as arthritis predating the injury. Before making a decision on any settlement you should seek independent legal advice or contact Workcover Advice and Assistance on 1300 794 744 for more information.

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