We get asked a lot of questions from Claimants about WorkCover Queensland claims and their compensation entitlements.
The purpose of this article to answer some of the more commonly asked questions, which we hope might be useful to Claimants.
Can you claim WorkCover for a pre-existing injury?
If a worker sustains an injury during the course of their employment, they are entitled to lodge a WorkCover Queensland claim.
It is quite often the case that a worker might aggravate a pre-existing condition. For example, a Claimant may have had previous issues with their lower back in the past but at the time of a new work event, they were asymptomatic. If the worker then aggravates their lower back injury, say as a result of lifting something heavy, they are entitled to lodge a claim with WorkCover.
It will be important for the doctors to differentiate the extent of the pre-existing condition and the aggravation injury, together with the permanency of any aggravation injury.
It is often essential to have appropriate expert medico-legal evidence to properly address this.
We run a number of matters for Claimants who were asymptomatic at the time of the work event who then suffer from a permanent aggravation to a pre-existing condition. It is important to seek legal advice as early as possible with respect to any potential WorkCover claim.
It is also important to note that even pre-existing injuries that are symptomatic at the time of the work event can be compensable. If a work event has made the symptoms worse, this would still qualify as a compensable injury. Again, it is important to seek legal advice as soon as possible.
What Injuries can you Claim on Workers’ Compensation?
There are number of injuries that can be claimed under WorkCover Queensland. If a work-related injury or illness happens to you (if you are a worker) or to one of your workers (if you’re an employer), there are potential entitlements through WorkCover Queensland.
An example of some of the injuries that workers can claim under WorkCover are as follows:
- Psychological or psychiatric injury;
- Industrial deafness;
- Work related respiratory diseases such as silicosis;
- Critical injuries;
- Back injuries;
- Shoulder injuries; and
- Ankle injuries.
In certain circumstances, workers injured whilst travelling to or from work can also be compensated for an injury sustained. For example, if you were driving to work and were rear ended on the way to work, a Claimant would be entitled to lodge both a WorkCover Queensland claim and a CTP claim.
If a worker dies as a result of work, a family member who was dependent on the person who has died, such as their partner or children may be able to lodge a claim with WorkCover Queensland.
It is important to get immediate legal advice regarding compensation entitlements should a work-related injury be sustained.
How Long Does a WorkCover Claim Take to be Approved?
The timeframe for a WorkCover claim to be approved varies. The first step is to lodge a WorkCover Queensland Claim Form together with a Workers’ Compensation Medical Certificate completed by your treating doctor.
Generally speaking, WorkCover must then make a decision with respect to whether your claim is accepted or rejected within 20 business days of receiving your claim.
In certain circumstances, WorkCover may take longer to make a decision if there is outstanding information they require. WorkCover should be communicating this clearly with the Claimant. It may be the case that further information is required from the employer.
Can an Employer Dispute a WorkCover Claim?
An employer can dispute the acceptance of a WorkCover claim. If WorkCover accepts a claim, the employer is entitled to dispute that decision and they must lodge an appeal with the Workers’ Compensation Regulator (“the Regulator”) within 3 months of WorkCover making the decision to accept the claim.
WorkCover will notify you if your employer has taken such a step to lodge an appeal with the Regulator.
It is important to seek immediate legal advice regarding your entitlements should this occur. There are strict time limits involved in Regulator appeals and the Regulator will advise a Claimant of an appeal lodged by the employer and provide a right of reply. Again, this is where it is important to obtain legal advice so you are fully aware of your rights and entitlements.
How Long Do You Have to Lodge a Claim with WorkCover Queensland?
For an injury that occurs as a result of a single incident event, a claim with WorkCover Queensland must be lodged within 6 months of that event. This time limit is usually applied very strictly by WorkCover Queensland and it is important not to delay in lodging a claim if there is an entitlement.
Some injuries occur over a period of time, for example, heavy repetitive tasks at work being undertaken over a number of months resulting in a back injury. For an over period of time claim such as this, a claim with WorkCover must be lodged within 6 months of first attending on a medical practitioner. A medical practitioner can include doctors and nurses at a hospital and is not confined to your regular GP. It is therefore essential that a claim is lodged as soon as possible after the first consultation.
It is important that workers are aware there are also very strict limitation periods with respect to common law entitlements.
For a single event injury, a compliant Notice of Claim for Damages must be lodged within 3 years of the date of incident, failing which the claim may be statute barred.
For an over period of time claim the 3-year limitation date starts from the date the work was first subjected to the harm. There is the potential for this date to have occurred many years ago and outside of the 3 year limitation date. It is therefore essential to seek immediate legal advice regarding steps that may be taken to protect an expired or expiring limitation date.
