Workers Compensation Regulation 2016

An exception to the standard method of determining the appropriate Table 1 costs for a claimant and an insurer based upon the meaning of “resolved” under clause 2 of this Part and the types of resolutions set out in Table 2 applies, where—

a claimant has made an application to the Commission to resolve a dispute about permanent impairment and pain and suffering pursuant to sections 66 and 67 of the 1987 Act, and

the section 67 claim has been substantiated by—

a report, from a medical specialist with qualifications and training relevant to the body system being assessed who has been trained in the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, to the effect that the claimant has sustained 10% or more whole person impairment where—

the injury was sustained on or after 1 January 2002, and

that report has been served on the insurer, or

a medical report to the effect that the claimant has sustained a loss or losses of 10% or more of the maximum amount referred to in section 66(1) of the 1987 Act where—

the injury was sustained before 1 January 2002, and

that report has been served on the insurer, and

the medical assessment certificate issued by a medical assessor or Appeal Panel is to the effect that the degree of whole person impairment of the claimant is below 10% or the loss or losses are not 10% or more of the maximum amount referred to in section 66(1) of the 1987 Act.

In a case to which subclause (1) applies—

the claimant is entitled to maximum costs in the amount of $4,400, and

the insurer is entitled to maximum costs in the amount of $2,062.50.

In this clause—