Spinal surgery including neck fusion rates in Workers’ Compensation populations worldwide are high. Revision surgery on the cervical spine and other areas including the lumbar region are also high, while the numbers able to return to work are low (1).
If you have sustained a cervical spine injury (or neck injury) at work you may need neck fusion surgery for nerve root impingement, a herniated disc etc. If so, you may be entitled to claim a Workers’ Comp settlement for a lump sum in NSW for whole person impairment for a permanent injury.
You are also entitled to other benefits besides those for your surgical procedure for your work injury, including weekly wages and future medical expenses, and physical therapy as part of your Worker’s Comp claim.
Claiming a Workers’ Comp Settlement
It’s very rare for a Workers Compensation insurer to let injured workers know what their rights are with regard to claiming lump sum payments for permanent impairment caused by a neck or any other work injury.
The average Workers’ Comp settlement amount you may receive for permanent impairment is added to your rights to receive Workers’ Compensation benefits and medical expenses.
It’s good to know that even if you do receive a lump sum settlement for permanent impairment for your neck fusion surgery, it doesn’t stop you from also receiving your weekly payments for lost wages, medical bills and current and future treatment expenses.
Claiming a Lump Sum Settlement for Neck Fusion
If you’ve been injured at work and your treating doctor believes neck fusion surgery is required, you need the personal injury specialist lawyers at PK Simpson in Sydney to help you claim a lump sum compensation payment. We know the right expert doctors who are experienced and knowledgeable about neck fusion surgery can properly assess your injury and its likely success and medical care outcomes.
You will also need to consult other specialists for your workplace insurance company to gain a complete understanding of your whole person impairment. We also know how an insurance company may try to lessen the amount of your spinal fusion settlement.
How is My Workers’ Compensation Assessed?
After you’ve consulted your doctor and/or specialists for treatment and diagnosis of your work related injury, you will be assessed using guidelines established by Workcover, now SIRA. This assessment involves an independent medical examiner deciding on your percentage of Whole Person Impairment (WPI).
The outcome will determine if you are entitled to receive a lump sum compensation payment for your level of permanent impairment. Your claim is lodged with the Personal Injury Commission of NSW, which was previously known as the Workers Compensation Commission.
The level of WPI is vital when assessing a worker’s ongoing entitlement to Workers Compensation. The medical specialist who assesses your impairment will determine your level of impairment using the two methods of evaluation: the DRE (Diagnosis Related Estimate) method and the ROM (Range of Motion) method. The following percentages relate to the cervical spine whole person impairment (WPI) rate:
- DRE Category I – 0 per cent WHI
- DRE Category II – 5-8 per cent WHI
- DRE Category III – 15-18 per cent WHI
- DRE Category IV – 25-28 per cent WHI
- DRE Category V – 35-38 per cent WHI
On the basis of the findings on examination, the medical assessment determines which category of DRE impairment a neck injury meets. Doctors look for the following findings:
- Absent reflexes
- Alteration of motion segment integrity
- Asymmetry of spinal motion
- Cauda equina syndrome
- Muscle spasm
- Muscle guarding
- Non-verifiable radicular pain
- Weakness and loss of sensation
Whole Person Impairment (WPI) Additional Considerations
A medical assessment of more than 10 per cent for a neck injury will require radicular symptoms, which include loss of reflexes, sensory loss, atrophy or loss of muscle strength. These findings are objective and reported by a medical practitioner on examination. To qualify for the higher Category IV WPI and obtain a WPI of greater than 20 per cent for your Workers’ comp claim, you must have had spinal fusion or disc replacement surgery.
Spinal Fusion Claims Surgery and WPI
If you had spinal fusion surgery, you may claim for additional impairment for the effects of the cervical operation including serious complications. Neck or any cervical fusion surgery with no leftover or lingering symptoms may attract an additional whole person impairment of between 1-3 per cent.
However, such surgery with residual symptoms can attract a further WPI of between 2-3 per cent. Revisions or second surgeries may attract between an additional 1-2 per cent WPI for each. Spinal or neck fusion is equivalent to disc replacement surgery.
Compensation lump sum amounts payable for claims made on or after 19 June 2012 are set out in the table below:
For injuries sustained after August 5, 2015, the amount payable for lump sum compensation has increased according to the table below:
To claim lump-sum compensation for permanent impairment for your neck injury and resulting cervical fusion surgery, you will need to contact specialist personal injury lawyers such as those at PK Simpson in Sydney. We can help you negotiate the Workers’ Compensation maze and give you the best chance of success.
We strive to see you gain more than just an average Workers’ Compensation settlement to help you on your long road to recovery. For more detailed legal advice and information on spinal fusion settlements, contact our expert PK Simpson law firm so our personal injury lawyers can help you today on 1300 757 467.
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