Workcover Claims - Workers Compensation

WorkCover scheme

To obtain WorkCover benefits (well known as "Workers Comp") you must be a worker and in most cases you are someone on PAYE wages, although this is not always essential. If you are a sub-contractor who is self-employed or 'work' predominantly for one employer you may still be classed as a 'worker' under the legislation. If you at all unsure the first thing you should do is call Legal Compensation assistance service on 1300 850 441.

If you are classified as a worker and injured then your entitlements can include weekly payments for time off work (loss of earnings or a percentage thereof), payment of agreed medical expenses and potentially a lump sum payment for an permanent impairment. In certain circumstances you can also look at a common law (negligence) claim which could supply financial compensation for the genuine loss and compensation rather that the statutory (lower) amount available under the Workers Compensation claim legislation. If you at all unsure the first thing you should do is call Legal Compensation assistance service on 1300 850 441.

If you do not meet the two criteria (being a worker and suffering an injury) the insurance company or statutory body may still deny benefits. In such circumstances you may have appeal rights and it is important you obtain immediate legal advice and the first thing you should do is call Legal Compensation assistance service on 1300 850 441.

Statutory benefits

If you are a worker who suffers an injury you are entitled to statutory benefits including:

Weekly payments for time off work towards loss of earnings.
Payment of agreed and authorised medical expenses; and
A possible lump sum for any permanent impairment if the accident happened at work or travelling to or from work.

WorkCover - Lump Sums and Damages Claims

Once a WorkCover claim has been lodged on your behalf and accepted by either WorkCover or the insurer they will then pay your loss of earnings or percentage thereof at the agreed rate. The rate can vary and also if your earnings include items such as commission, overtime, etc. you may well not be entitled to payment of these aspects of your earnings.

Once the claim is lodged WorkCover or the insurer will meet any agreed medical expenses. As a rule you need to obtain authority from them before you incur medical expenses as any unauthorised expenses may not be paid.

WorkCover or the insurer may also offer you a lump sum payment once your injuries have stabilised if there is a permanent aspect to the injury, this is a statutory benefits under the scheme. You do not need to prove negligence or fault for the injury occurring to claim these benefits. The size of any lump sum paid is based on the level of the permanent impairment which has been sustained. This will normally require to be assessed by an appropriately qualified medical specialist is assessed medically and depends on the nature and extent of your injury.

As an alternative to any lump sum payment which WorkCover or the insurer may offer, you could be entitled to elect to sue your employer's insurer or WorkCover for negligence and claim damages (in some cases you may actually be able to do both). To succeed in a common law claim you must be able to establish that your injury was due (at least partially) to a fault in the workplace (i.e. negligence) and you must satisfy other specific liability and threshold criteria.

Claims outside WorkCover

The WorkCover system is complex and many variables apply in considering whether it is more favourable for a claimant to attempt to bring a damages claim under WorkCover or outside WorkCover. That is why you require the assistance of a specialist such as those at Legal Compensation.

The following are situations where claims outside the WorkCover system can occur:

Genuine sub-contractors are outside the statutory WorkCover scheme. They get no statutory benefits and any claim for damages is treated as a common law claim unless they hold their own Workers Compensation Insurance.
If you work for a labour hire agency you are entitled to statutory benefits but a damages claim is usually made as a common law claim against the host employer at the time.
If you are injured by the negligence of another organisation working at the same place, you are entitled to statutory benefits but a common law claim may be possible against that other organisation for their negligence.
If you are injured by faulty equipment, a claim for negligence or breach of warranty may possibly be made against the supplier of the equipment for the injury sustained.

There are potential advantages and disadvantages of being outside the WorkCover system that need to be considered and evaluated depending on the facts of each individual case. The first thing you should do is call Legal Compensation assistance service on 1300 850 441.

Hoops and hurdles - Liability issues in damages claims

The workers compensation laws clearly favours employers and disadvantages employees by making it difficult to obtain fair compensation for injury and by protecting employers interests. This has also unfairly been added to by individual State Governments introducing unfair thresholds and limits to claims, irrespective of fault or negligence.

Because of the unfair nature of the legislation and the different issues that need to be considered you really do require the assistance of a specialist in workplace injury compensation. The first thing you should do is call Legal Compensation assistance service on 1300 850 441.

Time limits apply, insurance companies want to pay you as little as possible - speak to specialist now.
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