6.2.3.2 Determine & calculate IB entitlement

The whole person impairment (WPI Whole person impairment) percentage confirmed by an independent impairment assessment (IIA Independent impairment assessment) is used to calculate the compensation amount for the claimed date of injury.

For claims lodged on or after 18/11/04 Agents are not bound by the WPI percentage assessed by the impairment assessor but must take this into account to determine the WPI and calculate the compensation amount.

Process

Follow these steps to calculate the entitlement to impairment benefits.

Step Agent action
Gather details about WPI levels

Gather details about the WPI levels for physical and psychiatric impairments and total loss injuries for the one work-related event

Use the tables provided to find indexed compensation amounts.

See: Compensation tables

If there are no total loss injuries

Use these compensation tables:

Physical impairment

  • Compensation table for physical impairment
  • Compensation table for modified Chapter 3 impairment (for injuries sustained on or after 3 December 2003)
  • Compensation table for Chapter 3 spinal impairment (for claims lodged or claims with the first Impairment Assessment on or after 10 December 2009).

Psychiatric impairment

Further injury hearing loss impairment

  • Compensation for Further Injury Hearing Loss impairment (for claims lodged on or after 18/11/04).
  • look up the three compensation amounts for physical impairment (where applicable for the date of the claim or date of injury) and/or whole person psychiatric impairment percentage and/or further injury hearing loss impairment percentage, in relation to the claimed date of injury
  • calculate up to three separate entitlements:
    • the greater compensation payable for the three physical impairment calculations
    • compensation payable for psychiatric impairment
    • compensation payable for further injury hearing loss impairment.
Impairments determined at 71% or more

The worker is entitled to receive compensation calculated at the relevant date that compensation is determined rather than the date of injury if the worker has:

  • lodged a claim on or after 10/12/09 or
  • has lodged a claim before 10/12/09 but attended an impairment examination after 12/12/09 or has not as yet attended an impairment examination

If the worker’s entitlement was paid under the previous provisions of the Act, the worker is entitled to have their entitlement re-calculated based on the ‘relevant date’ and to be paid any difference in compensation. Issue a new Notice of Liability and Entitlement.

The total amount of compensation cannot exceed the s98C maximum indexed amount.

See: Compensation table for physical impairment | Compensation table for psychiatric impairment

If there are total loss injuries

If there are total loss injuries, calculate the worker's entitlement for both physical impairment and total loss and offer the worker the highest of the two.

Calculation 1

Total loss entitlement calculation using the No disadvantage compensation table.

or

Calculation 2

Non-economic loss entitlement calculation using the Compensation table for physical impairment.

For injuries on or after 12/11/97 to 2/12/03

For calculation 1

Note: The maximum amount payable under no disadvantage compensation table for a single incident is $351,700 (which is indexed annually by date of injury).

or

For calculation 2

  • look up the WPI percentage determined by the Agent using the Compensation table for physical impairment
  • for claims lodged on or after 10 December 2009 or claims with the first impairment assessment on or after 10 December 2009, look up the WPI impairment percentage separately under Chapter 3 for a spinal impairment only (Compensation table for Chapter 3 SPINE impairment )
  • determine a total for calculation 2 (either payment under combined WPI for physical injuries or the modified Chapter 3 WPI entitlement or the Chapter 3 Spine WPI entitlement - whichever equates to the higher payment).
For injuries on or after 3/12/03

For calculation 1

Note: The maximum amount payable under no disadvantage compensation table for a single incident is $351,700 (which is indexed annually by date of injury).

or

For calculation 2

  • look up the WPI percentage determined by the Agent using the Compensation table for physical impairment.
  • look up the WPI impairment percentage separately under Chapter 3 only excluding total loss injuries. See: Table of modification to degrees of impairment
  • for claims lodged on or after 10 December 2009 or claims with the first Impairment Assessment on or after 10 December 2009, look up the WPI impairment percentage separately under Chapter 3 for a spinal impairment only, excluding total loss injuries (Compensation table for Chapter 3 SPINE impairment).

Apply statutory maximum

Determine a total for calculation 2 (either payment under combined WPI for physical injuries or the modified Chapter 3 WPI entitlement or the Chapter 3 Spine WPI entitlement – whichever equates to the higher payment).

For the final total, apply the statutory maximum.

The maximum compensation payable for multiple injuries sustained on the same occasion is indexed annually. The compensation payable must not exceed this amount. If necessary, reduce the compensation to the statutory maximum amount.


Deduct any previous impairment compensation

Deduct compensation from an impairment claim if there has been a previous maims and pain and suffering claim paid for the same injury.

The compensation amount for the impairment claim must be reduced by the total amount of any maims and pain and suffering payments if the amount of impairment assessed for the current claim includes any impairment or loss of use of the same body part involved in a previous claim.

If a claim lodged on or after 18/11/04 is a further injury hearing loss claim refer to Assess further hearing loss. An equation confirms the workers entitlement, a deduction of the previously paid amount does not occur.

For claims lodged on or after 29/07/2010

If the worker has been paid compensation for an injury that occurred by gradual process due to the nature of the employment or arose out of or in the course of employment, the worker is not entitled to further compensation for maims, pain and suffering or non-economic loss if the injury was sustained:

  • before the compensation was paid and
  • the injury materially contributed to a previously compensated impairment.
Provide notice

After the final compensation liability and entitlement is calculated update the claim file.

See: Create notice of entitlement

Loss of a foetus

If the injury is for a loss of a foetus, an impairment assessment is not required. Determine the appropriate amount of compensation payable using Summary of legislated formulas.

Note: If necessary consult a suitably qualified person (technical) before you pay compensation.

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