Request for two summary tables

Some of you may have received a request that a second summary table be included in your report. Here’s why:

In the Return to Work scheme, the %WPI is used for more than a lump sum payment for economic loss. %WPI is used for decisions about other benefits, and some areas of the legislation require that % to be inclusive of deductions and others not.

For instance, where the worker has received a prior lump sum payment from WorkCoverSA based on a Table of Maims assessment made pre-April 2008 (before whole person impairment assessment under AMA5 came into play in SA) the impairment information has to be provided in two ways. This only happens where the current injury is an aggravation, acceleration, exacerbation, deterioration or recurrence of the prior injury for which they were paid.

We need to be able to see the %WPI without the deduction for the prior injury in the first table so that the dollar amount can be taken off the worker’s payment for non-economic loss.

We need to be able to see the %WPI with the %WPI deducted for the prior injury in the second table to make the appropriate decisions around the worker’s entitlements for the current injury.

While it might seem that this is a job that could easily be worked out by the claims agent or self-insured employer, the legislation says that the decision must be based on the accredited assessor’s report, so we must ask that you include the extra table.

If a second summary table is required, this will be explained in the request letter. The assessment for the pre-existing injury must be based on relevant assessable information from our current guidelines/AMA5 and cannot be simply a guess. If there is not adequate information provided for you to ascertain a %WPI for the previous injury, please explain that in your report and do not make a deduction for that injury.

An example of how the two summary tables are used is shown below:

In this case study, the worker had a prior claim for a lumbar spine injury in 2001, which resulted in discectomy surgery at L4/5. The worker received a lump sum for permanent impairment under the Table of Maims method assessed at 20% loss of function of the low back and lumbar spine.

The worker suffered a further lumbar spine injury in 2013 which resulted in spinal fusion surgery at L4/5. The worker is seeking his further lump sum entitlement.

The first table provides an assessment of the %WPI for the current lumbar spine impairment.

• Assessed as lumbar DRE Cat IV with additional 3% WPI for ADLs. 

Summary Table 1 – Total lumbar spine impairment

The second table provides an assessment of the %WPI for the total lumbar spine impairment but reduces this by the %WPI for the pre-existing impairment

• Previous impairment able to be assessed using DBE method as DRE Cat III

Summary Table 2 – Work Injury impairment for injury 15/08/2015