TAC impairment benefits
A TAC impairment claim, also referred to as a TAC impairment benefit, is a lump sum claim that is open to someone to pursue if they have suffered permanent impairment as a consequence of a motor vehicle accident.
It is a lump sum claim that does not require fault. That is, you do not need to show that someone else was a fault and at that fault cause your accident and injuries, in order to pursue a TAC impairment benefit lump sum.
A TAC impairment benefit lump sum is considered to be compensation for pain and suffering.
You can pursue an impairment benefit claim once your injuries have stabilised.
This means that they are not getting any better and not getting any worse – they have played out.
The reason that your injuries need to be stabilised is that you are getting compensated for permanent impairment.
The TAC needs to know what permanent impairment you are left with before you can be compensated.
Generally speaking, 12 months post accident is when an injury can be considered to be stable although sometimes it can be quicker than this, and other times longer, depending upon the nature of the injury or injuries.
How do I lodge a TAC impairment claim?
In order to lodge an impairment claim, if you want to do it yourself you need to complete an impairment benefit claim form.
This is a standard form of the TAC’s and can be found online.
On the form you need to provide your details, including your TAC claim number.
You need to detail the injuries for which you are claiming and also outline any whole person impairment percentage ratings that are associated with those injuries.
These whole person impairment ratings are provided by specialist doctors that have assessed your injuries.
If you have a lawyer, then likely your lawyer will organise for you to be assessed by specialist doctors who will grade your injuries.
They will put percentage figures on each of your injuries and then these percentage figures will be added together to form one overall percentage figure.
This overall percentage figure then lines up with a compensation amount.
In relation to being medically assessed, you will need to see doctors to assess all of your injuries sustained in the accident.
These doctors will have different specialities.
So if you have a spinal injury or a shoulder injury for example you may have seen an orthopaedic surgeon.
If you have internal injuries you may have seen for example a gastroenterologist.
If you have psychological injuries you may have seen a psychiatrist.
If you don’t have a lawyer, you can still lodge the claim yourself but the TAC will organise the assessments for you and for this reason we recommend that you get legal advice so that a lawyer can assist you and guide you down the right path in terms of assessments.
Along with any medico-legal assessments, information will need to be provided from your treating doctors.
This might be in the form of medical reports from your treating doctors and other health practitioners you’ve seen.
It may include other medical material such as imaging reports.
The final thing that needs to be provided is what the TAC call an applicant statement. Again, if you have a lawyer they will sort this out for you.
A TAC applicant statement is basically a short statement that outlines who you are, what happened in the accident, and the injuries you’ve suffered.
Once the application has been compiled and all material obtained, then it needs to be sent off to the TAC.
It can be lodged via the TAC online portal or alternatively it can be lodged via email or by post.
What happens once the TAC impairment application is lodged?
The TAC then needs to consider the application.
This can take several months.
They consider all the material and in some cases, will accept the assessments completed by any doctors that have assessed you.
In this case they will send you or your lawyer correspondence and let you know that they accept all the assessments and therefore will pay you according to the overall whole person impairment assessment.
For example, say that the doctors have you assessed you was having a whole person impairment rating overall of 20%. This would then entitle you to $21,480
Sometimes what will happen is the TAC may request further information.
For example, they may want to clarify a medical issue that’s raised in in a report.
They may wish you to undergo further imaging in the form of an MRI or CT scan.
They may then wish for that material to be sent off to a doctor for comment.
They may dispute an assessment completed by a doctor and wish to have you assessed by another doctor or they may wish for that doctor to provide further comment clarifying his position.
If you agree with the TAC position
Then you can elect to resolve your impairment benefit.
The TAC will then pay you the agreed amount generally within a few weeks from the date that you agree to accept.
The TAC will send you or your lawyer a document to sign which indicates your acceptance.
This is called a release document. By signing this document it means that your claim is finalised and cannot be reopened in the future – even if your injuries get worse.
If you disagree with the TAC’s position
Say for example the TAC are wanting to resolve your impairment claim at 15% but you think you should be assessed at 30%.
At this point we would recommend having a lawyer to assist you. It may be a good idea to pursue a dispute application.
A dispute application initiates a conference with the TAC.
This is a conference which is normally conducted over the telephone where the parties try and reach an agreement.
There’s a few different outcomes in a case like this that may be reached.
What may happen is that the parties come to an agreement to resolve the matter for somewhere between 15% and 30%. So a compromise may be reached.
If further information is obtained prior to the conference supporting your position, then the TAC may agree to increase their offer from 15% to whatever can be proven on the evidence or otherwise negotiated.
If the matter can’t resolve at the conference, then if you wish to pursue it further the next step is to issue proceedings in the Victorian Civil and Administrative Tribunal (VCAT).
The job of VCAT is to consider the evidence and then make a decision based on the evidence.
If you wish to pursue the matter to VCAT then I would strongly suggest that you have a lawyer to assist you.
TAC permanent impairment payout amounts
As mentioned above, what happens is the doctors that you see each put a percentage figure on the injuries that they are able to assess and these figures then get combined into one overall figure.
So say for example that you are assessed as having an overall whole person impairment rating of 20% – that would equal $21,840.
If you were assessed for example at 30%, that would equal $43,540.
If you were assessed at 53%, that would equal $95350.
Keep in mind that if you have a lawyer, most lawyers will bill you for work done.
So say for example you were assessed at 20% and elected to accept $21,840, some lawyers might bill you several thousand dollars for their work in relation to this claim.
So keep in mind that this overall figure will need to be reduced if you have a lawyer.
TAC impairment benefit examples
Below are some example TAC impairment benefit matters.
Gary
Gary was involved in an accident while riding his bike in regional Victoria (in many instances, a person is covered by the TAC if they’ve been involved in a bicycle accident involving a vehicle).
In this example, a car failed to give way to Gary and collided with him.
Gary suffered injury to his right wrist and forearm, right hip, and lower back, and right knee.
Once his injury has stabilised, Gary was assessed by the appropriate specialists.
He was assessed as having a 25% whole person impairment rating.
An impairment claim was lodged on Gary’s behalf and after it was considered by the TAC, they elected to accept the assessments of all of the doctors that assessed Gary.
The TAC then offered to resolve the matter at 25% being $32,690. Gary elected to resolve the matter and accepted the TAC’s offer.
Sarah
Sarah suffered injury in a motor vehicle accident. She was a passenger in a vehicle driving over the crest of a hill.
As the vehicle in which she was travelling reach the crest of the hill there was a vehicle on the other side of the road.
The driver of the vehicle in which Sarah was travelling took advice of action swerving off the road and collided with a tree.
Sarah suffered serious injuries in the form of neck and back injuries, as well as an injury to her left shoulder.
She also required a significant amount of counselling after the accident.
Sarah was assessed by the appropriate specialists and was assessed as having a overall whole person impairment rating of 35%.
An application for impairment benefits was sent off to the TAC who after determining the matter disagreed with the overall impairment percentage figure.
In the TAC‘s opinion, and more appropriate assessment was 23%. The TAC took issue with the assessments relating to her spinal impairment.
Sarah, prior to the accident had had some issues with her spine in previous years and the TAC were of the opinion that the doctor that assessed her spinal impairment did not adequately take into account her pre-existing issues.
A dispute application was lodged and the matter negotiated between the parties.
The matter resolved on the basis that Sarah be assessed as having a whole person impairment rating of 30% entitling her to a impairment benefit claim amount of $43,540.
Also, as she was assessed as having a whole person impairment rating of 30%, she was assessed as having a serious injury application which is an important step to claiming common law damages (discussed further on this page).
Do I have to lodge an impairment claim if I’m going to pursue a common-law claim for damages?
In some cases, you can skip the lodgement of an impairment claim if you are going to pursue a common law claim for damages.
This is because an impairment claim is considered compensation for pain and suffering.
If you succeed in a common law claim for damages, anything that you received under an impairment claim will be taken into account.
So in some cases it does make sense to lodge a common law claim and skip the lodgement of an impairment claim.
What sometimes happens is an impairment claim in a common law claim can be lodged at the same time and the TAC will then pay one figure for the common law claim and forget about the impairment claim (but taking into account what you might have received by way of an impairment claim).
Will a TAC impairment claim impact on my entitlement to income payments?
No, a TAC impairment claim will not impact the payment of income payments from the TAC in any way.
Will a TAC impairment claim impact on my entitlement to claim medical and like expenses?
No, again, a TAC impairment claim will not impact the payment of medical and like expenses in any way.
Can I pursue an impairment claim by myself or do I need a lawyer?
You certainly can pursue an impairment claim yourself. Many people have before.
However, in our opinion it makes sense to have a lawyer to represent you in relation to an impairment claim.
There’s a few reasons for this.
The first is that if you have a lawyer they choose the doctors that you will be assessed by.
A lawyer will usually use doctors that they’ve worked with before.
The second and more significant reason is these claims can be technical as far as interpretation of the medical side of things is concerned.
When there is an argument as to what the appropriate whole person impairment rating is relating to a particular injury and if you don’t have experience and knowledge as to how injuries are calculated and the relevant issues involved, then it becomes very difficult to work out what you’re entitled to.
How long does an impairment claim usually take?
Before you can lodge an impairment claim your injuries need to be stabilised. All injuries that you suffered in the accident need to be stable.
A good guideline as to when injuries have stabilised is 12 months post accident although sometimes it can be less than this, sometimes more depending on the nature of your injuries.
If surgery is required then this can usually add to the time of stabilisation.
In terms of preparing the claim, it can take several months for you to be assessed by the appropriate doctors.
This obviously depends upon the nature of your injuries and the number of doctors that you are required to be assessed by.
Once your claim goes in the TAC will generally take anywhere from 2 to 6 months to determine the claim.
If you’re happy with their initial offer and you wish to accept it then compensation generally gets paid to you within a few weeks from the date of acceptance.
If however you wish to push on and not accept their offer because you believe you’re entitled to more under an impairment claim, then this will obviously add to the claim time.
