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Every year, thousands of Australians injure themselves during work or in other work-related accidents. A majority of these individuals will make a claim for Workcover compensation or Workers compensation. However, the unfair treatment of insurance companies and independent medical examiners towards them can often result in unnecessary delays, inadequate compensation, or even outright denial of compensation. Hence, workcover solicitors fight for your legal rights to ensure that you get the compensation you deserve.
The workcover compensation scheme is a complex area of law, and it comprises common law and legislation. While it is possible to file a claim independently, workcover solicitors have adequate experience and skill to handle your claim for you and ensure you have the legal documents and evidence you need.
Moreover, with years of legal training, litigation experience, and various meetings with different insurance companies for workcover compensation claims, we understand the legal complexities of such cases. Additionally, we know the way insurance companies and their solicitors work and the many legal implications that we may have to address while representing your claims and appeals.
Workcover Compensation Schemes
It is typically a form of insurance that offers compensation when an individual suffers from a work-related injury. In Australia, there are eleven main workers compensation systems. Over time, all 8 Australian States and Territories have developed their individual workcover compensation laws.
Moreover, the relevant legislation will govern each workers compensation scheme. Each legislation or Act has its own terms to define a work injury. Additionally, in many States, your work-related injury must be a result of your job during the course of your employment.
In the event that you are in a car accident on the way to or from work, or on other work-related journeys, which results in an injury, then you may be able to make a claim. Many common work-related injuries can include but are not limited to – Back injuries, spinal injuries, fractures, burns, electrocution, musculoskeletal injuries, loss of eyesight, industrial deafness, and COVID-19 due to exposure in the workplace.
Gathering medical evidence
This is a crucial element in your case that supports your claim. This evidence can include a medical certificate, medical reports, and hospital records wherever applicable. However, you may need to undergo a medical examination by an independent medical examiner. They will review your clinical notes, x-rays, and other records while examining you and prepare a report with additional feedback on whether or not they agree with your doctor’s assessment. The report will also include their diagnosis and any treatment they may recommend.
However, many individuals feel they may have a biased opinion due to their association with the insurance company. In the case that they disagree with the doctor’s assessment, you may also obtain another opinion from another medical professional that you choose. However, it is best to communicate with a workcover solicitor who is qualified to give you an independent legal opinion in your case.
Financial Compensation
A majority of superannuation funds in Australia also offer coverage for a disability insurance benefit – Total Permanent Disability (TPD) benefit. Depending on the terms of your insurance cover, this TPD benefit can be significant and help you regain the lost control over your life. Generally, it isn’t dependent on the cause of your injury or illness. Many individuals who suffer an injury at work or in a public place can make a claim for TPD compensation. However, each case is unique, and it is crucial that you primarily discuss this with your solicitors first.
The amount of compensation you get will depend on the type of injury and its impact on your daily life. Moreover, the legislation covers complex formulas for calculating your compensation benefits. This is another reason why we recommend you to seek legal advice while handling your claim, so you are aware of the compensation you deserve.
The insurance company will give you a limit of compensation. However, it is crucial that you manage this matter legally to calculate the actual amount of compensation. In most cases, insurance companies may aim to pay out as little compensation as possible.
In the case that you need to make sure you obtain your maximum entitlements under the law, it is important that you do not rely purely on the information your claim officer offers for your claim. Additionally, each compensation system will vary, but a general rule applies to all systems. If they accept your claim, you may receive benefits for lost wages, medical treatment expenses, and any permanent or psychiatric impairment.
Death as a result of work-related injury
In the case that a family member dies due to a workplace accident or injury, then the deceased’s family members may be able to make a claim for the death benefit. It includes lump sum payments, funeral costs, and other weekly payments for any dependents.
What if I’m unhappy with my workcover decision?
In the case that you disagree with the final decision regarding your workcover claim, then you may have the right to file for a review. The Workers’ Compensation Regulator is an independent body responsible for any reviews of the workcover decisions. While reviews don’t involve any hidden costs, it is important that you know –
- The review of the decision will include decisions to accept or deny your claim, decisions to end compensation benefits, and decisions to alter compensation amounts.
- You can ask for a review of the decision within 20 business days from the day you filed your claim. Workcover will then have five business days to offer you reasons for their decision.
- If you receive the reasons from workcover and still don’t accept the decision, you have 90 days from the date of the letter to apply for an official review.
Workcover disputes can be a result of various reasons. However, in each case, it is crucial that you know your rights and entitlements. While it can be difficult to know your legal options, an experienced workcover solicitor can advise you of your legal rights and start a claim on your behalf to ensure maximum compensation.
Also Read: Canberra Worker’s Compensation Lawyers and Solicitors
What happens if my case goes to the Medical Assessment Tribunal?
In such cases, their decision will be final, and you can not file for an appeal. Moreover, the tribunal primarily involves a complete medical examination of the claimant, abiding by the limitations of the claim. The tribunal usually consists of a number of medical practitioners who specialize in the different areas of injury that the claimant may suffer from.
However, the medical assessments at this tribunal are very careful, professional, and extensive. You can make written statements or submissions through a workcover solicitor. They will represent you and send the written statements to draw attention to certain areas of the claim. However, it is important to note that you may do this under very rare circumstances.
What should I do if I believe I have a workcover claim?
It is important that you seek independent legal advice immediately to evaluate your options. It helps ensure the best chance at a compensation claim. Moreover, failure to do so may impact your potential to make a compensation claim and could negatively impact your entitlements.
You must evaluate your case and see which scheme applies to your work injury case, whether you’re eligible for the claim, and what benefits will be available to you. Moreover, if your work injury claim also involves another party’s negligence, then it may be possible that you can claim lump sum compensation for your work-related injury.
In such cases, your lawyer may require further information for your workcover compensation claim, which involves an interview of witnesses, a review of the investigation of work injury reports, and the involvement of experts to evaluate the circumstances of the accidents that led to the injury.
Whatever your situation may be, time limits are crucial in such claims. Hence, it is important that you seek medical and legal help immediately to begin your treatment and legal process as soon as possible.
Since there are time limits involved in such claims, you must contact a workcover solicitor and evaluate your legal options immediately. Moreover, in a situation like this, it can be difficult to manage legal complexities with your injury and medical treatments. Hence, we recommend shifting the legal burden on the professionals and prioritizing your health.
Talk to a United Legal Lawyer today
At United Legal, we help defend the rights of injured workers and their families while defending your case against insurance companies. Moreover, we understand how different ways insurance companies can delay or even reject your claim, which is why we carefully build a strong case for you to ensure maximum compensation.
If you need independent legal advice, please don’t hesitate to reach out to our team of experienced lawyers. We are dedicated to your legal rights and work on a no-win-no-fee policy to ensure you get obligation-free legal advice.
At United Legal, our lawyers value your individual experience and offer personalized legal advice for every unique case. Contact one of our lawyers today.
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