WorkCover lawyers Colac

WorkCover is designed to help people who have been injured at work get back on their feet after an injury, and to compensate them for any impairment they may have.

WorkCover allows injured people to lodge a claim for compensation for injuries caused or aggravated by their work.

What kind of injuries are covered by WorkCover?

WorkCover covers a wide range of injures, including the following:

• Work-related physical injuries (the injury does not have to be severe or significant).
• A worsening, deterioration, or recurrence of injuries, diseases, or illnesses
• Injuries sustained while on breaks.
• Cancer, strokes, diabetes, heart disease, degenerative, or mental health disorders that are worsened or exacerbated by work.

You may be entitled to compensation if you can demonstrate a connection between your work and your injury.

How can I make a claim?

1. Notify your employer of your injury:

This should be done within 30 days of the injury. However, if the injury happened to occur outside of this time frame (for example, a number of years ago), you might still be eligible for compensation. Ensure to lodge a claim as soon as you’re able to do so, once you have decided to go down the WorkCover route.

2. Fill out and submit a WorkCover claim form:

Your boss, your union, a post office, or your lawyer can provide you with the relevant WorkCover claim form.

3. Obtain a Certificate of Capacity from your treating medical pracitioner:

If you’re just intending to pursue a claim for medical and like expenses, this isn’t necessary. You don’t need to have a certificate of capacity to claim medical expenses.

If you need time off work or intend to claim weekly payments, you will need a certificate of capacity. You should make sure that once you obtain a certificate of capacity, you provide a copy of it to your employer as soon as you can. Any delay in obtaining or providing a certificate of capacity can mean a delay in payment to you.

WorkSafe should also be provided with a copy of the WorkCover claim form.

Keep a copy of your claim form, any certificates, and any other injury-related documents. Sometimes documents get lost and you may be asked to provide a further copy.

If you need assistance lodging an initial claim from WorkCover lawyers in Colac, Claven Burdess lawyers can assist.

What happens after the claim is lodged?

Within 10 days, the employer should send the claim form to its WorkCover insurer. 

The insurer then has 28 days to determine the claim. If they don’t do so, your claim is considered to be automatically approved. For this reason it is important to keep an eye on the relevant dates.

You must go to a doctor’s appointment if the insurer requests you to do so during the determination period. If you don’t, your claim will likely be rejected.

You are not obligated to speak with any investigators during this period. Sometimes the insurer will organise for an investigator to contact you to take a statement. 

Once the claim has been determined, you may receive a call from the insurance company advising you of the outcome. You should also receive a letter advising you of the outcome.

If your claim is rejected, the letter will list reasons as to why it was rejected. If you disagree with the decision, you can appeal the matter to conciliation. You should seek support from a representative that knows the WorkCover system if you elect to appeal such a decision.

Some people believe that if their claim has been rejected by the insurer, that there is little hope that this decision will be altered. This is not the case. There are many occasions where the insurer has rejected a claim and it has later been accepted.

What are my entitlement options if my WorkCover claim has been accepted?

1. Payments of weekly income:

Your pre-injury average weekly earnings are used to calculate your weekly payments (PIAWE).

The maximum weekly payment rate is $2,000, which is double the state’s average weekly earnings.

Depending on the details of your employment, you might be eligible for injury make-up pay on a case-by-case basis.

If you have received benefits for more than 52 weeks, your employer will be forced to pay superannuation (consecutive or not).

If you do not make reasonable efforts to engage in recovery, retraining, and return to work programmes, there is a chance that your benefits will be stopped or terminated by the insurance company.

Return-to-work plans should be established with the help of your treating doctor.

2. Reasonable medical and other out-of-pocket expenses:

Health, hospital, nursing, personal and household, occupational, rehabilitation, and emergency facilities are also covered by WorkSafe.

Doctor, chemist, physiotherapy, and chiropractor bills, as well as specialist appointments and surgery, are all generally covered if they are approved first by the WorkCover insurer.

Mobility aids and special equipment, as well as home and car modifications and transportation costs, are all protected again, if approved by the Insurer.

Medical costs are generally paid for at least 52 weeks and often longer after the right to weekly reimbursement ends.

Claven Burdess lawyers can assist if you need a WorkCover lawyer in Colac for a weekly payment or medical and similar expenses matter.

3. Lump sum compensation:

In the event of a work-related injury, you might be entitled to additional lump sum benefits, including:

Claim for Impairment: Possible Lump Sum Claim #1:

If you suffer a persistent disability, you could be eligible for a lump sum payment.

When the injury is stable, meaning the injury is not getting better or worse, an impairment claim can be lodged.

The process entails getting your injury evaluated by a medical professional who is specially trained to assess work related injuries. This doctor will also grade the injury and he amount paid is determined by the impairment grade given to your injury.

Claim for Common Law Damages (Potential Lump Sum Claim # 2):

If the accident was caused by your employer’s or a third party’s fault or negligence, you may be entitled to lodge a common law claim for a lump sum payment.

You have six years to file a claim from the date of your accident.

If you think your injuries were caused by your employer or someone else, you can seek legal guidance. Contact Claven Burdess lawyers if you need assistance from a WorkCover lawyer in Colac in relation to a WorkCover lump sum claim.

WorkCover claims for death of a worker:

The dependents of a worker who dies as a result of a work-related accident, sickness, or disease are entitled to compensation. A lump sum payment, as well as any pension, as well as medical and funeral costs, may be due. Dependents may be entitled to a common law claim for an additional lump sum if there is negligence on the part of the employer or anyone else.

Further points about WorkCover:

You have the right to choose the doctor who will treat you. If you don’t want to, you don’t have to consent to be seen by a doctor recommended by your boss or anyone else. It is entirely up to you to decide how you want your injury to be managed.

WorkCover is responsible for paying travel expenses for medical or recovery services.

If you’re going to claim taxi expenses, make sure WorkSafe approves them first. If you drive, keep track of your mileage and upload it to WorkSafe for reimbursement.

Keep a journal of how your disability affects your social and family interests, as well as your desire to engage in sports and hobbies.

You are legally entitled to copies of any medical records received by the insurer in connection with your claim.

Certain treatment or service requests can take up to 28 days for WorkSafe to respond. After the time period has passed, you can refer the matter to conciliation.

WorkSafe will not pay your weekly payments unless the information on the reverse side of the medical certificate is complete and correct.

WorkCover medical certificates, which you can get from your doctor, usually last for 28 days. If you plan to be gone for more than 28 days and won’t be able to get an update certificate in that time, you can ask the insurer for approval to get a medical certificate that covers a longer duration.

Your WorkCover entitlements would not be affected if the company goes out of business. WorkSafe can make you a direct payee.

A severance package or redundancy payments will not be affected by the lump sum. However, before resigning from your job, you should seek advice to ensure that everything goes as smoothly as possible for you.