Maurice Blackburn

Your rights to Workers' Compensation and benefits under the Safety, Rehabilitation and Compensation (SRC) Act 1988.

Who can claim compensation?

If you are a government employee, or an employee of a company licensed to operate under the Comcare Scheme, and you suffer an injury at work, you can claim compensation under the Safety, Rehabilitation and Compensation (SRC) Act 1988 (Cth). You are covered whether you work full-time, part-time or as a casual.

What illnesses and injuries are covered?

Compensation is payable for injuries sustained at work or an illness caused or contributed to by your employment.  This includes the following:

• Physical injuries such as an injured back, arms or legs. It also covers an aggravation, i.e. worsening of an existing injury or disease by a work-related accident or illness.
• Injuries suffered while you are temporarily performing a work activity away from your place of employment.
• Injuries suffered travelling for work or while travelling to or attending an approved place of work or education.
• It is important to know that injuries suffered whilst travelling to and from work are no longer covered if sustained after 12 April 2007.  However, you may still be able to lodge a CTP claim if the road accident was not your fault.
• Injuries suffered whilst obtaining a medical certificate, medical treatment or undergoing a rehabilitation program or medical examination required by Comcare or your employer.

• Any illness caused by or contributed to by work is covered.  This includes pre-existing disease if work has aggravated the condition. Cancers and degenerative conditions can be aggravated by employment.  Also, the effects of strokes and heart conditions suffered at work are claimable.

How do I claim compensation?

To claim compensation, you must:

1. Report your injury in writing to your employer as soon as possible and complete an incident report.  Write down the name of any witnesses and their telephone number in case your employer disputes the circumstances of the accident or injury.
2. Visit your own doctor for treatment and ensure the injury or condition is recorded.  You can insist on seeing your own doctor before you see any doctor nominated by Comcare or your employer.
3. Lodge a claim form.  After the injury is reported, you should complete and lodge a claim form for time off work or medical expenses.  Claim forms are available from your Union, your  employer or from www.comcare.gov.au.
4. Get a medical certificate. This must be signed and completed by your doctor if you are claiming for time off work.  It should describe the injury and include the doctor's opinion about whether the injury is work-related.  It should also detail any time off work and further treatment required.

Always keep a copy of all documents related to your claim, including copies of your incident report form, claim form, receipts and invoices and any correspondence.

All accounts and receipts for medical treatment should be forwarded to Comcare or your employer.  If the claim is accepted, you will be reimbursed.

There is no time limit for a response to a lodged claim.  However a response is usually received within 4 - 8 weeks.  If your claim is rejected, and you want to appeal the decision, you must apply for reconsideration within 30 days.

What benefits are available if my claim is accepted?

Medical and similar benefits

You are entitled to payment of all reasonable medical expenses.  This includes surgery, hospital fees, nursing care, dental treatment, prescription medicine, medical aids, and treatment from registered physiotherapists, chiropractors, osteopaths and massage therapists.

Income support benefits

If you can't return to work, you are entitled to receive 100% of your normal weekly earnings for the first 45 weeks you are off work.  If you can return to work but not on your usual hours, you are entitled to a top-up payment.

After 45 weeks, if you are still unable to return to work, you will then be paid 75% of your normal weekly earnings. If you are able to return to work, but you are working less than your usual hours, you receive between 80% and 100% of your normal weekly earnings, depending on the number of hours you are able to work. This includes regular overtime, penalty rates, higher duties and some other allowances.

Lump sum payments for permanent impairment

If you suffer a permanent impairment as a result of your work-related injury, then you may be entitled to claim a lump sum permanent impairment benefit.  This does not impact your ongoing benefits, such as compensation for medical expenses.

To be entitled to receive a lump sum payment, you need to establish that your injuries have stabilised, which usually happens 6-12 months from the date of your injury or your last operation.  You also need a medical assessment that the injury is permanent.

Common law damages

If your injuries have been caused through the fault or negligence of your employer, the Act requires that you choose between either a Common Law claim for damages or a lump sum permanent impairment benefit. You cannot claim both and once a decision is made, it cannot be changed. It is therefore vital that you obtain legal advice before making your decision.

To be entitled to pursue a Common Law claim you must have a permanent impairment assessment of at least 10%. You have three years from the date of your injury to make a Common Law claim.

Common law damages claims against third parties

A third party is a person or organisation other than your employer.  It is common for workers to be injured due to the negligence of a third party.  Time limits are generally three years from the date of your injury. In the case of claims against another driver involving the CTP insurer of the vehicle at fault, the time limit is three years from the date of injury.

Common Law claims against third parties can affect your ongoing entitlements.  Seek legal advice at your earliest convenience.

Disputes

What if my claim is rejected or not accepted in full?

Comcare or your employer will send you a letter making a decision regarding your claim.  You must apply for reconsideration within 30 days.

What if my accepted compensation claim is terminated or my benefits are ceased?

Comcare or your employer may make a decision to stop your payments or medical treatment.  This may occur where Comcare determines that you no longer have an incapacity for employment or you no longer need some or all of your medical treatment. You must apply for reconsideration within 30 days. Extensions of this time may be possible.

What if my benefits are suspended?

Comcare or your employer can make a decision to suspend your benefits if you do not comply with, or refuse to sign, a rehabilitation program or a return to work program.  Such a decision has very severe consequences because it stops all benefits being paid to you or claimed by you.  If you are asked to sign a rehabilitation program or to accept a return to work program, first seek the advice of your doctor and obtain written advice as to what duties you are able to perform before you sign the program.  If your benefits are suspended you must apply for reconsideration within 30 days. Extensions of this time may be possible.

In all disputes a written reconsideration will be provided called a "Reviewable Decision". If it is not in your favour, Maurice Blackburn can advise you about the next steps to take, including taking your case to the Commonwealth Administrative Appeals Tribunal (the AAT). An application to the AAT must be made within 60 days of receipt of the reviewable decision.

Payment on the death of a worker

Lump sum compensation and a pension payment are payable to the dependants of a worker who has died of a work-related injury or illness.  Funeral expenses may be claimed to a maximum of $9,930.22.

Key time limits

Time limits apply to many steps that need to be taken to pursue a claim for compensation.  Maurice Blackburn is ready to advise you on this often complex area, making the process easier and less daunting and ensuring you receive what you're entitled to.

Notify employer of injury
As soon as practicable after injury (or death of the worker)

Reconsideration of a determination
30 days from the date you receive the determination

Application for review at the AAT
60 days from the date you receive the Reviewable Decision

Common Law negligence claim
Generally, three years from the date of injury

Permanent impairment claim
No time limit but should be brought after the injury has stabilised