Introduction
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 is also high, while the numbers able to return to work are low (1).
If you have sustained a work-related cervical spine injury (or neck injury), 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, future medical expenses and physical therapy as part of your Worker’s Comp claim.
Table of Contents
- Claiming a Workers’ Comp Settlement
- What Kinds of Injuries Cause Permanent Impairment?
- Claiming a Lump Sum Settlement For Neck Fusion Surgery
- How is My Workers’ Compensation Assessed?
- Medical Assessment of Your Workplace Injury
- Whole Person Impairment (WPI) Additional Considerations
- Spinal Fusion Claims Surgery and WPI
- Whole Person Impairment Compensation Table NSW
Claiming a Workers’ Comp Settlement
It’s very rare for Workers’ Compensation insurers to inform injured workers about their rights to claim 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 from your neck fusion surgery, it doesn’t stop you from also receiving your weekly payments for lost wages, medical bills, loss of earnings and current and future treatment expenses.
What Kinds of Injuries Cause Permanent Impairment?
The following permanent impairment table gives examples of injuries and procedures, including spinal surgery (which includes neck fusion surgery):
Physical injuries:
| Injury/ Procedure | Description |
| Disc bulges | Also referred to as sciatica |
| Surgery | Such as joint replacement and spinal surgery |
| Hearing loss | Where the hearing loss is work-related |
| Ankle or wrist fusion | Fusion results in loss of joint mobility |
| Multiple injuries | Injuries that affect multiple body parts |
| Knee, elbow and whole-person injuries | Where a range of movement is restricted |
| Eye injuries | Where eyesight is impacted |
| Nerve damage | Where the cause is work-related |
Claiming a Lump Sum Settlement For Neck Fusion Surgery
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 and can properly assess your injury, 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). An average settlement for spinal infusion surgery for a workers comp injury in Australia is based on this individual assessment.
The outcome will determine whether 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.
Medical Assessment of Your Workplace Injury
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 WPI
- DRE Category II – 5-8 per cent WPI
- DRE Category III – 15-18 per cent WPI
- DRE Category IV – 25-28 per cent WPI
- DRE Category V – 35-38 per cent WPI
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
- Atrophy
- Cauda equina syndrome
- Muscle spasm
- Muscle guarding
- Non-verifiable radicular pain
- Radiculopathy
- Weakness and loss of sensation
Whole Person Impairment (WPI) Additional Considerations
A medical assessment of more than 10 percent 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 percent 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 percent.
However, such surgery with residual symptoms can attract a further WPI of between 2-3 percent. Revisions or second neck fusion surgeries may attract between an additional 1-2 per cent WPI for each. Spinal or neck fusion is equivalent to disc replacement surgery.
Lump sum amounts payable for workers comp settlement for neck fusion claims and others are set out in the table below:
Whole Person Impairment Compensation Table NSW (June 2024):
| Degree of permanent impairment | Compensation range |
|---|---|
| 0 – 10% | $0 |
| 11% – 20% | $22,480 – $62,770 |
| 21% – 30% | $51,880 – $100,470 |
| 31% – 40% | $83,040 – $162,450 |
| 41% – 50% | $131,440 – $224,550 |
| 51% – 60% | $242,010 – $396,570 |
| 61% – 70% | $376,030 – $568,550 |
| 71% – 74% | $510,040 – $654,540 |
| 75% – 100% | $577,050 – $740,550 |
Source: SIRA Workers Compensation Benefits Guide – June 2024
Contact PK Simpson For Your Workers’ Compensation Claim Today
To claim a lump-sum compensation payment 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 in gaining a personal injury settlement.
We strive to see you gain more than just an average Workers’ Compensation settlement for neck fusion to help you on your long road to recovery. For more detailed legal advice and information on an average settlement for spinal fusion surgery workers comp Australia-wide, contact our expert PK Simpson law firm so our personal injury lawyers can help you today on 1300 411 596.
References
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06900-8
Frequently Asked Questions (FAQs)
If you have questions about Neck fusion surgery and whole person impairment (WPI) claims in New South Wales, you’re among the many. Below are some common questions and answers that can help clarify the WPI process, eligibility, and compensation details for injured workers.
If you’ve sustained a work-related cervical spine injury that requires neck fusion surgery, you may be eligible for a Workers’ Comp settlement. This typically includes compensation for permanent impairment, medical expenses, lost wages, and future medical care related to your injury.
Yes, receiving a lump sum settlement for permanent impairment doesn’t stop you from also receiving weekly payments for lost wages, ongoing medical expenses, and future treatment costs related to your work injury.
While not required, having a specialized Workers’ Compensation lawyer can significantly improve your chances of receiving a fair settlement. They can help navigate the complex legal process, ensure all necessary medical evidence is gathered, and negotiate with insurance companies on your behalf.
The settlement amount is primarily based on your Whole Person Impairment (WPI) percentage, which is determined by an independent medical examiner. Other factors include the severity of your injury, impact on your ability to work, medical expenses, and potential future medical needs.
The time frame for making a Workers’ Compensation claim can vary, but it’s generally advisable to report your injury and start the claim process as soon as possible. Specific time limits may apply depending on your location and the nature of your claim.
Neck fusion surgery, also known as cervical spinal fusion, is a procedure that joins selected bones in the neck (cervical spine). This surgery is typically performed to treat conditions such as herniated discs, spinal stenosis, or injuries that cause instability in the cervical spine.
Whole Person Impairment (WPI) is a measure of the impact of an injury on a person’s overall function. For neck injuries, it’s assessed using methods like the DRE (Diagnosis Related Estimate) or ROM (Range of Motion). The WPI percentage is crucial in determining the compensation amount.
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