Did you get hurt at work and still not back to 100%?
Some injuries resolve in a matter of weeks. Some are permanent. If yours falls into the second category, a number gets assigned to your injury… and that number can shape your whole claim.
It’s called a permanent impairment rating.
Here’s the problem:
Most employees only learn how it’s worked out when they’re sitting in a doctor’s office being evaluated. Not the best place to be learning the rules.
This guide breaks it all down simply.
What’s inside this guide:
- What Is a Permanent Impairment Rating?
- Where Ratings Fit Into a Victorian WorkCover Claim
- How Lasting Injuries Are Actually Measured
- The Thresholds That Matter Most
- How To Prepare For Your Assessment
What Is a Permanent Impairment Rating?
A permanent impairment rating is expressed as a percentage. It reflects the extent that your injury has permanently affected your whole body.
This is called Whole Person Impairment (WPI).
A score of 0% indicates no permanent impairment. The higher the number, the greater the permanent effect on your body’s function.
Think of it like this…
When you injure your shoulder, the doctor isn’t grading your shoulder. They determine how much your shoulder injury impacts your whole body. Therefore a severely injured shoulder could be only a small percentage of your WPI.
That catches a lot of people off guard.
The rating is also NOT based on how much pain you experience on a bad day. It is meant to assess prolonged loss of function. Are you able to bend/grip/lift/walk/concentrate/etc. like you used to? Those are the questions this rating addresses.
Where Ratings Fit Into a Victorian WorkCover Claim
Prior to any rating being done, a claim must exist. Wondering how to make a WorkCover claim in Victoria? It starts well before your impairment assessment. You notify your employer of the injury, obtain a certificate of capacity from your doctor and submit a workers’ compensation claim with all the appropriate forms and medical documentation. If you do these initial steps correctly, it will make the following processes run much easier.
Here’s why that matters:
Your impairment rating is determined by your medical records. If you filed your claim late, or the injury was not documented correctly it will be more difficult to prove the extent of damage afterwards. That’s why knowing how to make a WorkCover claim the right way matters from day one.
You are definitely not alone. Australia saw 146,700 serious compensation claims in 2023-24. That comes out to about 400 per day.
Most workers will make a full recovery. Some will not… and that’s where permanent impairment ratings come in.
How Lasting Injuries Are Actually Measured
Ratings in Victoria are administered under strictly controlled conditions. The assessment tools used by doctors are the American Medical Association Guides to the Evaluation of Permanent Impairment (4th Edition), with some state variation.
Waiting For The Injury To Settle
An injury cannot be assigned a rating if it is still improving. It must be “stable” with little chance of further improvement with treatment.
This is often called maximum medical improvement.
Typically, the assessment cannot be made until 12 months following injury at the earliest.
The Independent Medical Exam
You will be referred to an independent physician with experience in impairment ratings. If your injury is psychiatric, you will be referred to a psychiatrist.
During the exam, the doctor will:
- Review your medical history and scans
- Ask how the injury affects daily life
- Test movement, strength and function
- Compare results against the AMA Guides tables
Combining Multiple Injuries
Do you have multiple injuries? Each injury is evaluated separately. After that, they are combined using a unique formula.
Note: Combining is not the same thing as adding. Two 10% ratings won’t combine to make 20%. Use the table below to see how combined values work (always slightly less than simple adding).
| Individual Ratings | Simple Total | Combined WPI |
|---|---|---|
| 10% + 10% | 20% | 19% |
| 10% + 20% | 30% | 28% |
| 20% + 20% | 40% | 36% |
| 30% + 30% | 60% | 51% |
| 10% + 10% + 10% | 30% | 27% |
| 10% + 10% + 10% + 10% | 40% | 34% |
Physical vs Psychiatric Injuries
Physical and psychiatric injuries are evaluated separately. They are never combined to get to the threshold.
Many employees are caught off guard by that regulation, especially those who have both. You will get two ratings if you injure your back and become depressed as a result, not one.
The Thresholds That Matter Most
Here’s where the numbers really count.
Your WPI percentage determines which benefits you are eligible for. Thresholds for Victoria are as follows:
- Physical injuries: Usually requires WPI of 10% or more for lump sum impairment benefit
- Psychiatric injuries: the bar is much higher at 30%
- Weekly payments after 130 weeks: generally, applicants will require a WPI greater than 20% since March 31, 2024
Small percentages can make a big difference.
Nine percent versus ten could be the difference between a payout and empty hands. Accuracy is important.
Long-term claims also have significant impact. Claims involving more than 13 weeks off work accounted for 74.8% of compensation payments in 2022-23, despite making up only a fraction of claims.
In other words… Permanent injuries are where the big money (and the big disputes) are.
How To Prepare For Your Assessment
Show up prepared for an impairment evaluation. A few minutes of preparation can save your rating.
Here’s what to do:
- Keep a diary of symptoms. Record pain levels and what bad days were like and activities you can no longer perform.
- Bring all your records. Scans, specialist reports and treatment notes all help.
- Tell the truth. Don’t exaggerate your pain, and don’t minimize it. Just say how it really is.
- Describe how it impacts you every day. Describe actual activities such as picking up groceries, sleeping, driving.
- Speak up during tests. Say straight away if a movement causes pain.
Simple, right?
But here’s the thing…
Some employees attempt to act like they are “tough” throughout the exam. This can work against you. By working through pain to show the doctor how strong you are, you may end up with a lower score than you deserve.
What If You Disagree With Your Rating?
It happens more often than you’d think.
If you think the rating is unfair you can often dispute it. In Victoria, disputes can go to conciliation at the Workplace Injury Commission. Medical issues may also be referred to an independent Medical Panel for a binding opinion.
Act now. There are time limits for disputing a rating. Early legal advice can really help.
Bringing It All Together
Permanent impairment ratings can seem overwhelming. However, once you know the basics they are not so intimidating.
To quickly recap:
- A rating measures how much an injury affects your whole body
- Victoria uses the AMA Guides (4th Edition) with local changes
- Your injury must be stable before it’s assessed
- Thresholds of 10% and 30% decide access to lump sums
- Preparation and honesty protect your result
Your rating is a single number. But it can impact your money for decades.
Learn the rules. Collect your evidence. Question a rating you believe to be unfair.