Q&As: New regulation for limited deterioration claims for lump sum compensation

What is the change?

A new regulation will be made to enable injured workers who made a claim for lump sum compensation before 19 June 2012, to make one further deterioration claim from 19 June 2012.

Why is the change being made?
In a recent decision of the Court of Appeal, Cram Fluid v Green [2015] NSWCA 250, the court found that the ‘one lump sum compensation claim only’ limit under section 66(1A) of the Workers Compensation Act 1987 applies to all injured workers, including claims for lump sum compensation made prior to 19 June 2012.

This decision means that a worker who made a claim for lump sum compensation prior to 19 June 2012 and has received compensation, is precluded from bringing a further claim for lump sum compensation if their work injury condition deteriorates.

What will the new regulation do?
The new regulation will allow injured workers who made a claim for lump sum compensation before 19 June 2012 to make one further claim for lump sum compensation after this date.

This is consistent with the intent of the 2015 benefit reforms to make the NSW workers compensation system fairer and deliver more benefits to injured workers.

When will the change apply?

The new regulation will commence in November 2015 and will apply to workers who made a claim for lump sum compensation made prior to 19 June 2012.

Who will benefit?

Injured workers, regardless of their level of existing permanent impairment, will be able to:

  • make one deterioration claim on or after 19 June 2012 in respect of any existing impairment, for lump sum compensation.

There will be no restriction on the level of permanent impairment of the deterioration claim.

Note: If an injured worker has already made and received a deterioration claim on or after 19 June 2012, they are not entitled to a further claim.

A claim for lump sum compensation should only be made when the injured worker has reached maximum medical improvement.

I’m an injured worker, what do I need to do?

You will need to contact your insurer or a solicitor if you believe you are eligible to make one further deterioration claim.

Further information

For further clarification please contact the insurer directly. If you are unable to resolve your enquiry with them you may contact:

State Insurance Regulatory Authority (SIRA)
Customer Service Centre
T: 13 10 50
sira.nsw.gov.au