If you are injured at work you may be entitled to claim workers compensation

Published 13 Apr 2016
Louis Andreatta

Who can claim?

If you are an employee receiving wages or commission and you suffer an injury arising out of or in the course of your employment you may be entitled to claim workers compensation.

In certain circumstances, a contractor may also be entitled to claim workers compensation against the company that engages the contractor.

If your injury aggravates a pre-existing injury, you may be able to bring a claim.

If you are suffering from a disease and your work was the main contributing factor or if your work aggravated the disease, you may be entitled to bring a claim. For example, you may be able to bring a claim for chemically induced asthma or for industrial deafness.

In certain circumstances, if you suffer a psychological injury which was substantially caused by your employment, you may be entitled to claim compensation.

The benefits you can claim are:

• Weekly payments of compensation calculated as a percentage of your current wage which may persist for up to two and a half years if you are incapacitated for work for that period. However, you should note that if you have a residual earning capacity then your weekly payments may be reduced

• Medical, hospital, physiotherapy and prescription costs as well as costs incurred in travelling to and from medical providers.

• Where a worker has suffered an injury resulting in a permanent impairment of more than 10% whole person impairment, a worker may also be entitled to lump sum compensation.

Important steps to take when making a claim for workers compensation:

1. When an injury occurs at work, you should immediately notify your employer and require the employer to record details of the injury as well as the circumstances of the injury.

2. Visit a doctor as soon as possible after an injury. You may only receive benefits where a doctor has provided you with a WorkCover medical certificate. You will be required to sign your consent to the doctor releasing information to WorkCover and your employer's insurer.

3. Sign a worker declaration which is obtainable on the WorkCover website.

4. Give to your employer, the WorkCover medical certificate and worker declaration as well as any original receipts for evidencing your payment for treatment you have received.

5. You should request your employer to immediately notify their workers compensation insurer of your injury. When you have done these, your employer is obliged to inform WorkCover of your injury within 48 hours.

6. You may be entitled to provisional payments without having to submit a WorkCover claim form. If you do not receive provisional payments within seven days of notifying your employer of your injury, you should enquiry as to why you have not received your provisional payments.

What happens if you are still injured after seven days?

You are required to make all reasonable efforts to return to work. However, if your incapacity prevents you from returning to your pre-injury employment but you can do something, you are required to ask your employer to find "suitable duties".

Seven days after injury, you can nominate your own treating doctor to manage your injury in consultation with your employer and the workers compensation insurer.

When must the workers compensation insurer decide your claim?

The insurer has 21 days to either admit or deny your claim.

The insurer is required to inform you in writing if it decides to deny your claim. It must also give reasons for denying your claim.

Where an insurer denies your claim a worker may request an immediate review of the insurer's decision. If the insurer continues to deny your claim, you may request a WorkCover independent review officer to investigator your claim.

What you may receive if your claim is accepted or first 13 weeks after injury

You may be entitled to 95% of your pre-injury wages or the maximum weekly compensation amount (which you can find on the WorkCover website at www.workcover.nsw.gov.au), whichever is the lesser amount. After that you will be paid a percentage of your weekly wage for up to two and a half years if you remain incapacitated for that period. You will only be entitled to further weekly payments of compensation if you satisfy certain conditions and if you are suffering more than 20% whole person impairment.

In certain circumstances you may be entitled to sue your employer

If your injury has occurred as a result of negligence on the part of your employer and if you are suffering from more than a 15% whole person impairment, you may be able to sue your employer in negligence. If you sue your employer in negligence, you can only recover past loss of earnings and future loss of earning capacity.

Can Maclarens Lawyers help me claim workers compensation?

Yes.

Maclarens Lawyers can assist you and advise you in relation to your workers compensation claim and assist you to:

a) To take action if you haven't started receiving payments.

b) If your claim goes to the workers compensation commission, Maclarens Lawyers can assist you.

c) Maclarens Lawyers can assist you gather evidence to prosecute your claim if your insurer denies liability.

d) Maclarens Lawyers can argue your case before the Workers Compensation Commission.

e) If you are late in making a claim, Maclarens Lawyers can assist you.