In this blog, I will be discussing some basic concepts how the workers’ compensation system in Queensland works, how to get a claim started, what to do and what to avoid.
I’ve been injured at work – what should I do next?
For any worker who has been injured at work, the first and most obvious piece of advice is to seek medical treatment.
If you are taken from work or a worksite to a hospital or medical centre, the WorkCover claim can simply be commenced by the treating doctor preparing a workers’ compensation medical certificate and faxing this to WorkCover. WorkCover will then initiate the claim and allocation a claim number.
WorkCover will appoint a claim officer to the claim and will speak with you and your employer about how the injury happened, the injury or injuries and what medical treatment has been received so far and what ongoing medical and/or rehabilitation needs you might have.
You can also lodge your WorkCover claim by telephone or email or online via the WorkCover website www.worksafe.qld.gov.au
Some WorkCover claims are for medical expenses only if the injury is fairly minor while others will involve major work accidents and injuries where the injured worker may be unable to return to work ever and may require a lengthy period of time away from work.
My WorkCover claim has been accepted – what am I entitled to?
If the WorkCover claim is accepted, and most but not all claims are accepted, the injured worker will then be entitled to receive weekly benefits (or replacement wages) which is very much like income protection payments paid at 85% of your normal weekly earnings and WorkCover will also pay any and all reasonably incurred medical and rehabilitation expenses.
If an injured worker is on weekly benefits or is unable to work for six months, the rate of the weekly benefits drops down to 75% of normal weekly earnings and will continue at this rate for up to two years post-accident. At the two-year mark, the weekly benefits will either stay at 75% of normal weekly earnings if there is an impairment of whole person of at least 15% or it will then drop down to the Centrelink rate of benefits if the whole person impairment is less than 15%.
Most WorkCover claims do not continue for two years or longer, but some will take this long or longer if the injured worker has major injuries with long-term treatment and rehabilitation.
While an injured worker is receiving weekly benefits, WorkCover does not pay superannuation benefits although this can be claimed or recovered if there is a common law claim for damages.
When does my WorkCover claim end?
Your WorkCover claim can end or be finalized in a few different ways.
Generally, the WorkCover claim will end when the injured worker is able to return to work. There might be a suitable duties program or a return-to-work program or your doctor might give you a full clearance to return to work on full-duties.
Sometimes there can be a dispute or some concerns about whether the injured worker is able to return to work or not. Medical opinions can differ on this and sometimes WorkCover will send an injured worker to an “Independent Medical Examination” to one of the doctors or medical specialists on WorkCover’s panel so that WorkCover can receive a written report on the injured worker’s situation and ability to return to work.
WorkCover will issue a decision if they think the claim should end and the injured worker generally has three months to lodge an appeal against the decision with the Workers Compensation Regulator if the injured worker wishes to dispute the decision.
Your WorkCover claim can also end when your injury has stabilized or reached maximum medical improvement. At this point of the claim, WorkCover will obtain a report from one of their doctors to assess if you have been left with any level of whole person impairment and, if so, an offer of lump sum compensation will be made and this will be contained in a document called a Notice of Assessment. This is a very important document which has legal consequences. It is a very good idea to obtain legal advice at this point in time if not earlier.
My WorkCover has ended – what are my rights and options?
When WorkCover has issued a Notice of Assessment, the injured worker has obtained or accrued an entitlement to sue for common law damages.
Any common law claim for damages must be commenced within three years of the date of accident/injury.
If the whole person impairment is equal to or more than 20% then the injured worker can accept the lump sum offer and also sue for common law damages. However, if the whole person impairment is less than 20%, the injured worker cannot do both. A decision will have to be made about whether to accept the lump sum offer or pursue the common law claim. This is known as the irrevocable election. Once again, it is very important to obtain high-quality legal advice at this stage of the claim so you can be aware of your rights and options.
A quality lawyer will be able to advise you on your prospects of success, the likely full value of your claim and also provide a reliable estimate of the likely cost of pursuing the claim and your likely ‘in hand’ outcome if the claim settles early or if a trial is required. The vast majority of common law claims are able to be resolved and very few proceed to trial.
