When Can You Claim Workers’ Compensation?

Each year, unfortunately, there are many Australians who have been injured at work or have become sick due to their work. Many of these people may not fully understand what workers’ compensation is, if they are eligible, how they can make a claim and/or what their return to work obligations are, but don’t worry, the team at Anvil Legal are here to help!

What is Workers’ Compensation?

All employers in Western Australia are required to hold workers compensation insurance.

If a worker is injured whilst at work or the workplace duties have caused or contributed to an injury requiring medical assistance and/or time off work they may make a claim against the employer and the employer then forwards the claim to their insurer who makes a decision whether to accept the claim and start paying compensation to the injured worker or not. This should be done as soon as possible after the injury as it will take some time for this process.

If a claim is accepted workers’ compensation weekly payments should be made to the injured worker to cover wages while they are not fully fit for pre-injury duties as well as ‘reasonable’ medical expenses and vocational rehabilitation expenses (return to work providers).

What are the most common causes of Workers’ Compensation injuries?

Safe Work Australia’s latest Australian Workers’ Compensation Statistics Report [1] outlines that there were 114,435 serious workers’ compensation claims made in Australia 2018-19.

In the report, a serious claim is considered to be an accepted workers’ compensation claim for an incapacity that resulted in a total absence from work of one working week or more.

The main causes of serious claims (by the mechanism of injury or disease) were body stressing (36 per cent), slips, trips and falls (23 per cent) and being hit by moving objects (16 per cent). These three mechanisms together accounted for three-quarters of all serious claims.

But there were many other types of mechanisms of injury and diseases reported. These included mental stress, vehicle collisions, heat, electricity and other environmental factors, chemicals and other substances, biological factors, and sound and pressure.

What are the most common Workers’ Compensation injury types?

According to the aforementioned mentioned Safe Work Australia report, injury and musculoskeletal disorders accounted for 87 per cent of serious claims in 2018–19. And of these, the most common were traumatic joint/ligament and muscle/tendon injuries (accounted for 45 per cent of all injury and musculoskeletal disorders claims).

Diseases were responsible for 13 per cent of serious claims, with the most common being mental health conditions (68 per cent of disease claims).

COVID-19 has been the subject of much discussion: whether any workplace required vaccination, or catching COVID itself, causes a compensable injury will rely heavily on the facts.

How can I make a claim?

If you have been injured, immediately seek first aid and report the injury to your employer. After this, you must see a doctor, obtain a First Certificate of Capacity and then fill out a Workers’ Compensation Claim Form.

Make copies of both the Certificate and Claim Form for your records and then give the original documents to your employer.

Your employer has five working days to complete their section of the Workers’ Compensation Claim Form and to lodge both documents with their insurer. They could receive a penalty if they fail to lodge the claim within five working days.

The insurer should notify you within 14 days after receiving your claim form and the notification should indicate if the claim has been accepted, disputed or pended. If you have not been contacted by the insurer by 14 days, give us a call.

If your claim is accepted, you should receive weekly compensation payments within 14 days (if your injury prevents you from working) and compensation for your reasonable statutory expenses.

If your claim is disputed, no compensation will be paid, and the insurer will advise you of the reason why. If you disagree with the insurer’s decision, you should seek legal advice as it may require an application to WorkCover WA who is the Dispute Resolution Authority.

The insurer may put your claim on hold pending further information. The insurer then has another 10 days to make a decision on your claim. If the claim is still undecided after the 10 days have passed, the claim is deemed to be in dispute. If you disagree with the insurer’s decision, you should seek legal advice as it may require an application to WorkCover WA who is the Dispute Resolution Authority.

You should see your own GP through all of this, no one can dictate who you see for treatment purposes and no one has the right to attend treatment appointments with you unless you agree.

What are my return to work obligations?

In some cases, the severity or type of your injury may keep you away from work for weeks, months or even years.

According to the Workers Compensation and Injury Management Act (the Act), if you return to work within 12 months of the injury date and the position is no longer available your employer must provide you with a position that is comparable in status and pay, and that you are qualified and capable of performing.

If your employer wishes to terminate your employment during the 12 month period, they must give you and WorkCover WA 28 days written notice of their intention to do so.

If your doctor certifies you with some capacity for work the employer must establish a Return to Work Program which sets out your restrictions in hours and duties. Your employer must work with you and your doctor to develop this program; the insurer may ‘appoint’ a return to work provider, HOWEVER, you have the right to choose your own or terminate the one the insurer appoints if you believe they are not looking after you.

The program must detail the actions that will be taken to enable you to return to work and who is responsible for those actions. It must also contain a signed statement that you agree to the program.

How can Anvil Legal help?

Anvil Legal has significant experience as workers’ compensation lawyers in Perth and our staff have personal experience of how a work injury can affect the lives of you and others.

Our goal is to make your worker’s comp claim go as smoothly as possible. We can provide you with supportive and professional legal advice in respect of any ongoing claim issues, including, weekly payments, medical costs and whether any settlement proposal from the insurer is the best option for you or not.

Give us a call on (08) 6143 5200 today to discuss your claim or visit our website and request an appointment. We offer a No Win No Fee Workers’ Compensation solution to approved clients.

 

References:

[1] Australian Workers’ Compensation Statistics Report 2018-19, Safe Work Australia, 2021.

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