What You Need to Know About Workers Compensation Claims

Australia prides itself on taking workplace health and safety very seriously. Still, workplace injuries happen. Australian workers filed 120,355 workplace injury claims in the past year.

The consequences of a work-related illness or injury can be devastating, especially if you don’t know what steps to take.

One of the most important things to do after sustaining a workplace injury is to file a claim. If you don’t have experience with workers’ comp, you might be wondering, “What is a workers’ compensation claim?”

Keep reading to find out everything you need to know to protect your interests after a work-related injury or illness.

What Is Worker’s Compensation Insurance?

Workers’ compensation insurance functions as a safeguard for employees who get injured or develop an illness at work. Employers pay for workers’ compensation insurance to support their employees.

There are many different workers’ compensation schemes for Australian workers. These schemes vary among states and territories.

Workers’ compensation schemes cover full-time workers, part-time workers, and apprentice workers. In some cases, schemes also cover volunteers and temporary workers. Schemes don’t often cover contractors.

Workers’ comp insurance covers employees’ medical treatment when they get injured or ill during the course of work. Workers’ comp can even apply while travelling for work.

What Is a Workers’ Compensation Claim?

A workers’ compensation claim is the form a worker files after sustaining an injury or illness at work. Many workers enlist the help of a workers’ compensation lawyer when filing a work comp claim.

If the work comp claim gets approved, the injured worker gets compensated for their illness or injury. Workers’ comp benefits cover the following expenses:

• Medical treatment
• Hospital stays
• Rehabilitation
• Compensation for permanent impairment
• Lost wages
• Death and funeral costs

In addition, some workers’ comp schemes also cover psychological trauma and mental illness. It is important to check your workers’ comp scheme to find out exactly what it covers.

How To File a Workers’ Comp Insurance Claim

When you get injured or develop an illness at work, you will need to file a workers’ comp insurance claim. Here are the steps you should follow.

Notify Your Employer

It is vital that you notify your employer of your work-related illness or injury. You should do this as soon as possible after the injury occurs or once you become aware of the illness.

Failing to notify your employer within eight business days is an offence unless you have a reasonable excuse for doing so.

Seek Medical Attention

You should always get checked out by a medical professional when you get injured or develop an illness at work. This is not only for your well-being but for the purpose of documenting the extent of your injuries.

A medical professional will assess your illness or injury. Then they will determine the appropriate course of treatment. They will also provide you with a work capacity certificate.

In some circumstances, it may be necessary to seek medical attention right away. Always prioritize your health and well-being. Just make sure to notify your employer within the required time frame.

Sometimes, an employer may require you to see another medical provider of their choice. This is often done to provide additional proof that your injury or illness is work-related.

Hire a Workers’ Compensation Lawyer

Many people find it beneficial to use the services of a workers’ compensation lawyer.

A work comp lawyer will have the specific legal experience and expertise to get you the best possible outcome for your claim. They will walk you through the process and ensure you have the necessary evidence to support your claim.

Submit a Claim

With the help of your work comp lawyer, your next step is to file your claim through your workers’ compensation scheme. Your lawyer will make sure you file your claim properly to avoid any issues getting approved.

Workers’ Compensation Schemes and Resources

Workers’ comp schemes differ across Australia. It is important to check with your workers’ comp scheme to understand the terms of your coverage and how to file a workers’ comp claim.

Here is information about the various workers’ compensation schemes organized by territory.

Australian Capital Territory

The WorkSafe ACT comprises the Regulator and the Office of the Work Health and Safety Commissioner. It manages and administers workers’ compensation benefits.

New South Wales

The State Insurance Regulatory Authority provides an approachable claims management guide.

This guide includes information about workers’ comp legislation, regulations, and claims management. Their goal is to help insurers make the best decisions for communities and to help workers understand their rights.

Northern Territory

NT WorkSafe helps businesses and their workers understand their workplace rights and obligations. It is a division of the Department of the Attorney General and Justice.

It also provides information on safety, rehabilitation, and workers’ compensation.

Norfolk Island

The Norfolk Island Workers Compensation Agency offers many state services to the community. These services include courts and legal services, workers’ compensation, title registration, and others.

Queensland

WorkCover Queensland provides services and information about work health, safety, and workers’ compensation. It is part of the Office of Industrial Relations.

South Australia

ReturnToWork SA is responsible for regulating the return to work scheme for South Australia. It provides work injury insurance to protect both businesses and their employees after a work illness or injury.

Tasmania

The purpose of WorkCover Tasmania is to advance the safety, well-being, and work health of all Tasmanians. It promotes safe work practices, investigates workplace incidents, and performs compliance audits.

Victoria

WorkSafe Victoria is the workplace safety and health regulator for Victoria. It also provides workers’ comp insurance.

The goal of WorkSafe Victoria is to reduce harm in the workplace and provide beneficial outcomes for injured workers.

Western Australia

WorkCover WA regulates and administers the workers’ compensation scheme for Western Australia. It also informs employers and employees about how to manage workplace injuries.

WorkCover WA works in accordance with the Workers’ Compensation and Injury Management Act of 1981.

Comcare is a government regulator and workers’ compensation insurer for Western Australia. It works alongside employers and employees to minimize harm in the workplace.

Comcare collaborates with other workers’ comp schemes in Western Australia. Together they create innovative projects and solutions to improve workplace injury outcomes.

Safe Work Australia is a government statutory agency in Australia. It is developing policies geared toward improving workplace safety nationwide.

File Your Workers’ Compensation Claim

What is a workers’ compensation claim? It is the official form a worker must file after sustaining a workplace injury or illness.

Failure to file a workers’ compensation claim properly and on time can result in the loss or denial of benefits.

To ensure you get the best result, get the help of an experienced NSW workers’ compensation attorney. Contact Barwick Boitano Lawyers today to schedule a free consultation to discuss your case.

In a 2019-20 report, 120,355 serious injury claims were made by Australian workers while on the job.

Body stressing made up 37% of those claims. The highest frequency came from labourers, community, and personal service workers, along with machinery operators and drivers.

If you’ve had an injury while on the job, then you might be eligible for compensation. Want to know how much?

In this guide, we break down everything you need to know about workers’ comp payout in New South Wales (NSW).

What Is a Workers’ Comp Payout?

If you get injured on the job or become ill due to work in NSW, you should make a claim for workers’ compensation. It is sometimes referred to as ‘WorkCover’ which was the old name for the NSW workers’ compensation scheme.

This is the monetary compensation for injuries at your place of work. In NSW, you don’t have to prove that your employer was negligent in order to get workers’ comp. 

Instead, you must prove that the injury happened while you were working. This is a ‘no fault’ scheme.

If you had a work-related injury and work was a ‘substantial contributing factor,’ then you are covered. Even if your employer was not at fault.

The NSW worker’s compensation system offers support if you’re injured at work including compensation for:

• Lost Wages,
• Medical, Hospital, and Rehabilitation Treatment,
• Assistance to Help You Return to Work,
• And, Occasionally, Compensation for Non-Economic Loss.

The SIRA or State Insurance Regulatory Authority is the NSW Government agency that is responsible for overseeing the NSW workers’ comp system.

Jobs Not Covered by Workers’ Compensation

There are some occupations that are not covered by workers’ compensation in NSW. These include:

• Coal Miners Matters: Refer to the Workplace Injury Management and Workers’ Compensation Act of 1988.
• Dust Disease Matters: Refer to the Workers’ Compensation (Dust Diseases) Act of 1942.
• Bush Fire, Emergency, and Rescue Services: Refer to the Workers’ Compensation (Bush Fire, Emergency, and Rescue Services) Act of 1987.

To get workers’ compensation for these injuries, you must file a claim with NSW State Insurance Regulatory Authority (SIRA).

What Is Covered?

Some examples of injuries or damage that qualify for workers’ compensation claims in NSW are:

• Hearing Loss,
• Permanent Impairment,
• Property Damage,
• Serious Injury or Illness,
• Dangerous Incidents,
• Or Death.

Workers’ compensation only repays financial damages. So keep in mind that you can’t claim payments for ‘pain and suffering.’ These are non-economic damages according to the Workers’ Compensation Act of 1987.

Your Recovery Plan

Once you report your injury, your insurer gives you a claim number. This appears on all documentation relating to your claim.

What Is a Certificate of Capacity?

Your certificate of capacity is the main way your doctor communicates with your support team. The certificate outlines your injury or illness, your ability to work, and the treatment needed.

This information helps determine your injury management and recovery plans.

Who Is Your Support Team?

As you move towards your recovery and return to work, your support team is there to help you along the way.

The team includes your case manager, doctor, and employer. Together they communicate to ensure you’re on track for a complete recovery.

• Case Manager: This is the key person to help you with any questions or concerns about your recovery. They are appointed by your employer’s insurer and contact you within three days of being notified to talk about your claim.
• Doctor: Your personal doctor, of your choice, assesses, diagnoses, and treats you for your injury or illness. They complete your certificate of capacity and support you as you recover. Lastly, they communicate with other members of your support team.
• Employer: It is your employer’s job to nominate someone to support your recovery. Often referred to as a “return to work coordinator” they talk with you, your case manager, and your doctor about your recovery plan at work.

You may need additional providers such as a physiotherapist or psychologist to be part of your support team. Your insurer might also include a workplace rehabilitation provider to help.

Your Payout Options

If your claim is eligible for a workers’ compensation payout, then you may receive compensation in a variety of forms:

• Weekly Payments: Payments to compensate for your lost wages while you’re off work.
• Medical Expenses: Covers the cost of your medical, ambulance, hospital, travel expenses, and rehabilitation expenses.
• Permanent Impairment Payout: You receive a lump sum compensation payout. It covers any permanent impairment that was a result of a work-related injury or sickness.
• Work Injury Damages Payout: You receive a lump sum payout for damages if the injury or sickness was the result of your employer’s negligence. (Also known as a ‘common law claim.’

What Is the Maximum Payout?

There are some limits that could apply to your workers’ comp payout in NSW. For most, your maximum weekly payout is $2318.10 x 5 years. This is a total of $602,706.

However, there are some exceptions. If you have a permanent impairment that is greater than 20%, this limit doesn’t apply.

Plus, these weekly payments don’t include compensation for your medical, hospital, rehabilitation, travel, and ambulance expenses.

Finally, for successful lump sum claims, your total payment is on top of these amounts. A lump sum may also be available if you have permanent impairment. (However, this must be made before any damages settlements.)

What Should You Do Next?

Your rights should protect you if you’re injured due to a workplace accident or illness. Keep in mind that workers’ comp settlements are determined through negotiations with the insurer. 

Many people miss out on the full amount of their workers’ comp payout because they don’t understand the laws. If you need help with your workers’ compensation claim, then our specialist NSW workers’ compensation lawyers are here to help.

We want you to receive the financial assistance you deserve – so you can focus on your recovery instead of losing money. Contact us today for honest legal advice and support to put your mind at ease.

Everyone is bound to get injured on the job at some point. Some people can walk it off and return to work the next day without issue. Others suffer for years while trying to balance medical bills they can’t afford. 

If a person sustains an injury at work, the employer is the one responsible for providing some kind of coverage. It’s even more important if the injury will put this individual out of work indefinitely. Workers’ comp insurance is also the best option for an employer hoping to avoid a lawsuit. 

What is workers’ compensation insurance, and how does it protect you after a serious injury?

What is Workers’ Compensation Insurance?

Workers’ comp is a type of business insurance that provides financial support for a person injured on the job. It helps your employees pay their bills while they’re unable to work. It’s also a way to avoid an employee suing your company for an avoidable injury. 

Workers who accept access to workers’ compensation cannot sue for negligence against their employer. This goes even if the workers’ compensation does not fully repay the worker after an injury. The only option, in that case, is to fight for a bigger payout. 

Workers’ compensation insurance provides coverage for anything from minor injuries to death.

An injured worker expected to recover is entitled to income maintenance for about two years from the date of their first payment. The pay lowers from 100% of what is owed to 80% in the second year of receiving their compensation. 

Suppose the worker is seriously injured and has a permanent impairment. In that case, they are entitled to 80% of the difference between their average weekly earnings and any current earnings. 

Who is Eligible for Workers Comp in Australia?

Workers’ compensation isn’t available to all workers across the country. To qualify for it, your employer must offer it as an option. 

After an injury, your employer contacts the insurer they’re partnered with. They notify the insurer of your injury and can start the claims process from there. Alternatively, the workers can lodge a claim with the insurer. 

In Australia, workers’ compensation laws state that a worker does not need to prove that an employer was negligent. You qualify as long as you were injured doing something work-related.

Furthermore, any worker is entitled to receive compensation from their employer. 

What is Included?

Workers’ comp in Australia helps to provide compensation while you seek medical treatment, rehabilitation, or can’t work due to your injury. It also provides the same coverage if you get an illness at work related to your job. 

The type of claim you submit will determine what kind of coverage you receive. There are claims for disabilities, time off from work, and even death. 

Benefits you could receive include coverage for your medical treatment and income replacement payments. Unless you are permanently disabled due to your injury, the payments are usually cut off after two years. 

In the case of death, your family receives death or funeral benefits. This may also include support payments such as a lump sum compensation or weekly payments for your dependents. 

How Common Are Work-Related Injuries?

According to the Australian Bureau of Statistics Work-Related Injuries Survey, about 4.2% of employees experienced some kind of injury from 2017 to 2018. Of those injured, 39% did not take any time off work. Only 3.6% of them were unable to return to work. 

A quarter of all injured workers took 5 or more days off work but eventually returned. That’s all assuming there were injured individuals who submitted a compensation claim. It doesn’t take into account people who were injured on the job, and either did not or could not submit a claim. 

The frequency of worker injuries also depends on the industry. The most affected industries in Australia are transport, postal, and warehousing. After that, it’s agriculture, forestry, and fishing. 

Types of Injuries Covered by Workers’ Compensation

Generally speaking, injuries sustained on the job or at the workplace are considered work-related. These include hurting your back when transporting materials, slipping on a liquid, and developing a heat stroke on the job. As long as it wasn’t avoidable on your part, it’s considered your employer’s responsibility. 

Repetitive strain or stress injuries are common in a wide variety of workplace settings, and they’re usually covered by workers’ comp. However, some policies do not cover them since you could develop this issue at home. 

Similarly, injuries caused in part by a pre-existing condition may not get covered unless your employer was aware of the condition beforehand. 

Expect coverage for illnesses caused by on-the-job exposure. This includes exposure to asbestos or other airborne particulates.

You may also receive compensation for COVID-related injuries if you can prove that your work was a main contributing factor. 

How to File a Claim

In the case of a work-related injury, your employer may file a claim for you. You should also call your claims agent as soon as possible. Your workers’ compensation website may also have a portal to help you file a claim. 

Hiring a lawyer isn’t a necessity when you file, but it can help. Your employer may require that you file the claim yourself instead of going through them.

In that case, you want to make sure that you’re providing the correct information. It’s especially important if your specific claim comes with significant compensation. 

In the case that your claim is denied, you should receive a Section 74 Notice with all of your relevant information. If you believe this to be an error, your lawyer can challenge the decision with the Workers’ Compensation Commission. 

Get Coverage on the Job

What is workers’ compensation insurance for the average employee? It’s a way to continue getting paid even when you get hurt on the job. However, there are times when they deny a claim, and you’re left dreading what comes next. 

Barwick Boitano Lawyers has been providing legal services in Sydney’s West for over 30 years. We specialize in Personal Injury Law, Family Law, and more. Reach out to make a confidential appointment and to learn more about our services.