In New South Wales (NSW), workers’ compensation claims often involve employees with pre?existing health conditions such as chronic illnesses, past injuries, or degenerative diseases. These conditions complicate claim assessments and can significantly influence employer premiums. Understanding how the system treats pre?existing issues is essential for businesses navigating icare and the NSW Nominal Insurer.
What Counts as a Pre?Existing Condition?
A pre?existing condition is any health issue that existed before a work?related injury or illness. Common examples include:
- Chronic conditions: arthritis, diabetes, asthma.
- Previous injuries: back problems, joint damage, fractures.
- Mental health conditions: depression, anxiety, PTSD.
- Degenerative diseases: spinal degeneration, cardiovascular disease.
How Pre?Existing Conditions Affect Claims
- Under Section 323, impairments from pre?existing conditions must be deducted.
- Whole Person Impairment (WPI) assessments consider the worker’s total impairment, then deduct the percentage attributable to pre?existing issues.
- Employer impact: Workers may be compensated, but complex claims and longer recoveries raise premiums
Industries Most Affected
Recent data shows pre?existing health issues are particularly challenging in:
- Healthcare & Social Assistance: High stress and physical demands increase the likelihood of claims.
- Financial & Insurance Services: Rising psychological injury claims linked to workplace pressures.
Employer Responsibilities
To manage risks effectively, employers should:
- Maintain clear Policies & Procedures requiring disclosure of health issues that affect duties.
- Ensure Health Professionals tailor assessments to the specific job description.
- Document workplace adjustments to support employees with pre?existing conditions.
- Engage early intervention strategies to reduce claim escalation.
Strategic Recommendations for Employers
- Promote workplace health programs to reduce the impact of chronic conditions.
- Train managers to identify early signs of psychological stress.
- Partner with icare specialists like ABILITY GROUP to navigate complex claims and minimize premium increases.
- Stay updated on legislative reforms to ensure compliance and proactive risk management.
Conclusion
Pre?existing health issues are an unavoidable reality in today’s workforce. By addressing these challenges head?on, businesses can reduce costs, improve workplace safety, and strengthen resilience in an evolving compensation landscape.
For support or advice, please contact our people specialists for assistance.
Source: mcdonnellschroder.com
Title: Pre-Existing Conditions & Workers Comp: What You Need To Know