Maurice Blackburn

If you are injured at work you can claim compensation under WorkCover.  Maurice Blackburn can ensure that you obtain all the statutory benefits and compensation that you are entitled to.

We can provide you with advice if:

• your workers' compensation claim is rejected
• your workers' compensation benefits are ceased
• you want to know if you are entitled to lump sum compensation for your injury
• you have received an offer of lump sum compensation that you believe is not enough, or
• you want to know if you can claim damages from for your injury.

Who can claim compensation?

If you are injured at work, or in the course of your work, you may be entitled to claim compensation.

Your injury must occur in Queensland or your principal place of employment must be in Queensland.

You may be regarded as a worker even if you are a subcontractor or you hold your own insurance policies. If you are not regarded to be a worker, you may have other entitlements under public liability law.

What injuries are covered?

Injuries suffered during breaks and journeys to and from work are covered in most circumstances. It doesn't matter if the injury was your fault (other than in cases of serious and wilful misconduct). Injuries include aggravations of diseases, psychological disorders, hearing loss and aggravation of degenerative conditions.

The information applies to all injuries sustained on or after 1 January 2005. For injuries prior to that date the law may be different. Maurice Blackburn can advise you in relation to this.

When should I claim?

All injuries should be reported to your employer as soon as possible. A claim for weekly payments and medical expenses is generally only valid if lodged within six months of the injury occurring. If it is lodged more than 28 days after the injury occurs, WorkCover will not pay you for the first 28 days.

The entitlement to compensation arises on the day you are assessed by a doctor. It is therefore important to consult a qualified medical practitioner as soon as you can after sustaining injury. Physiotherapists, chiropractors and naturopaths may be helpful for treatment, but they are not doctors.

A claim for compensation known as 'common law damages' must be lodged within three years from the date of the injury or when you first knew of the injury.

Extensions of time are sometimes possible, but you should speak to Maurice Blackburn immediately if your injury happened more than three years ago.

A claim for lump sum compensation for permanent impairment has no time limit, as long as WorkCover originally accepted liability for the claim for weekly payments and/or medical expenses.

How do I claim compensation?

You can either complete a WorkCover claim form (available from all WorkCover offices or via the WorkCover website), ask your doctor to lodge a claim form for you or call WorkCover on 1300 362 128 and lodge your claim form over the phone.

You will also need a WorkCover medical certificate from your doctor, which must be lodged with WorkCover. You should also notify your employer. Make sure you keep copies of all documentation and note the date you lodged the form with WorkCover. Maurice Blackburn can help you to lodge your claim correctly and ensure you have provided the right information.

When must WorkCover respond?

WorkCover has 20 business days to decide whether or not to accept your claim for physical injuries. You may be asked to attend a medical appointment with a WorkCover doctor. You must cooperate with such a request.

WorkCover also has the right to ask you to provide a statement and any other proof of the injury and its cause.  Be sure to seek advice before giving WorkCover any statement.

What if my employer says 'Don't make a claim, we'll just pay you'?

This is illegal. You should never accept compensation in place of lodging a formal compensation claim.

If my claim is accepted what do I get paid?

Weekly payments

Your employer pays the first $500 of lost wages. After that WorkCover pays in accordance with the following table:

Worker's employment is governed by an 'Industrial Instrument''	0 - 26 weeks	26 weeks - 5 years
Total incapacity	Usually 85% of the worker's normal earnings	Usually 75% of the worker's normal earnings

Partial incapacity is calculated by using a more complex formula, Maurice Blackburn can explain and simplify the process for you.

What medical expenses are covered?

WorkCover is only required to pay the cost of medical treatment that it considers reasonable. Prior approval must be obtained from WorkCover before undergoing any treatment, such as surgery, physiotherapy, psychological counselling or chiropractic treatment. Get your treating doctor to make this request on your behalf.

WorkCover also imposes limits on the amount of treatment and your right to claim medical treatment ceases when your entitlement to compensation ceases. If you are unhappy with the decision by WorkCover regarding medical treatment seek advice from Maurice Blackburn.

What if my claim is rejected or my payments stop?

You have the right to ask for review of the decision by a Government body known as Q-Comp. The request for review must be lodged within three months from the date you receive notice of the decision.  If a medical report is obtained, the doctor may charge for the cost of the report, although this can be reimbursed if the decision is reversed. If Q-Comp again rejects the claim, you have 28 days to lodge an application with the Magistrates court or the Industrial Relations Commission. You should obtain legal advice before appealing any decision from WorkCover.

Can I dispute other decisions made by WorkCover?

There are limited rights to dispute other decisions by WorkCover. Strict time limits do apply and Maurice Blackburn can provide you with advice in relation to this.

Who is responsible for my rehabilitation?

If you are entitled to compensation, WorkCover must take steps to rehabilitate and return you to suitable duties. If WorkCover has not made proper attempts to rehabilitate you, a written request should be made to the Claims Officer handling your file.

You also have an obligation to participate in rehabilitation as soon as practicable after the injury is sustained and whilst the entitlement to compensation continues. Failure to do so may result in your compensation being stopped.

However, it is important to know that just because your employer or a WorkCover doctor says you are fit for work, doesn't mean you have to comply. Follow your own doctor's recommendation.

Do I have to tell anyone if I return to work after claiming compensation?

You have a legal obligation to notify your employer and WorkCover of a return to work within 10 business days.  Severe penalties may apply if you fail to do so, including a loss of your right to sue for damages.

Can I claim a lump sum?

Impairment lump sums

A claim for lump sum compensation can be pursued from the time your injury is assessed for permanent impairment. This should only occur once your injury has stabilised and it is deemed unlikely to improve with further medical treatment.

Impairment is assessed according to WorkCover regulations and often by the Medical Assessment Tribunal, which is usually a panel of two or three doctors. Maurice Blackburn can help you make a request and can protect your interests at the Medical Assessment Tribunal.

If you have a work-related impairment (WRI), WorkCover will make an offer of lump sum compensation. The document is called a Notice of Assessment. If you do not respond to the lump sum offer within 28 days, your decision is simply deferred. WorkCover will often pressure workers to accept the impairment lump sum as it usually saves them money if you do.

If your work-related impairment is under 20% you will have to choose between accepting the lump sum offer and claiming common law damages. You can't have both. Your choice is final and it is essential you seek legal advice before making this decision.

If your work-related impairment is 20% or more, you can accept the lump sum and claim common law damages.

Don't sign or accept a WorkCover Notice of Assessment without getting legal advice.

Common law damages

If your injury is someone else's fault, you may be able to claim common law damages. You can still claim damages even if the injury was partly your own fault. Damages include compensation for:

• pain and suffering
• loss of enjoyment of life
• lost income, past and future
• past and future medical treatment expenses
• past and future medication and travelling expenses
• loss of past and future superannuation contributions.

You can claim common law damages even if your impairment has been assessed at 0% and the amount of damages claimable is unlimited.  There is a strict three year time limit to claim damages from the date of injury or the date you first became aware of the injury.

It is essential you seek legal advice about your right to claim damages.

What is the process?

The process is usually simple and informal. The WorkCover law requires a compulsory pre-Court procedure. This means Court proceedings cannot be commenced until there has been a full exchange of documents and evidence. All parties must then sit down together and participate in a compulsory settlement conference. Approximately 70% of all damages claims resolve at the first compulsory settlement conference.

How long will it take?

The time frame from impairment assessment to compulsory settlement conference is usually 9 - 12 months.

Death claims

Common law damages and/or impairment lump sums can be claimed where a worker dies due to a work-related injury or disease. This can include heart attack, stroke or even suicide.

10 commonly asked questions about WorkCover

1.   I have received a lump sum offer from WorkCover. Should I just accept it?

No. Always get legal advice regarding any offer. Accepting an offer without getting advice could cost you tens of thousands of dollars.

2.   Can my employer sack me while I'm on compensation?

No. Your employer can't sack you on the grounds of disability or for making a claim for compensation. Employers will often use other reasons, most commonly that you are no longer fit to perform your pre-injury duties. Maurice Blackburn can help ensure your rights are protected.

3.   Will WorkCover send investigators to follow me around?

It is common practice for WorkCover to engage investigators to check on claimants. If you are honest about what you can and can't do and what work you are doing this cannot harm your claim.

4.   Am I obliged to be treated by the company Doctor?

No. The employer cannot force you to accept treatment from their doctor. You are entitled to choose your own doctor and to decide what treatments you will undergo. You may have to attend company or WorkCover doctors only for the purpose of the preparation of medical reports or to assess fitness for duties.

5.   Can WorkCover force me to return to work?

Injured workers are obliged to participate reasonably in rehabilitation programs. This doesn't mean you must return to work as directed by the company doctor or the WorkCover doctor. The details of a return to work program should be given to you in writing. You should then consult your own doctor and follow their recommendations.

6.   What happens if WorkCover closes my file?

Closure of your file does not finalise your rights. If WorkCover terminates your entitlements they must send you a letter informing you of that decision and you should contact Maurice Blackburn for advice.

7.   Can I claim compensation even though I have left that employer?

Yes. It is still possible to claim WorkCover even though you have left that employment. However strict time limits apply and you should contact Maurice Blackburn for advice.

8.   Does it matter if my employer has gone out of business or moved since the accident?

No. WorkCover Queensland will cover the employer, under a contract of insurance.

9.   If I sue my employer will I lose my job?

Your employer can't sack you for pursuing your right to damages. The damages are paid by WorkCover, not your employer, under a contract of insurance.

10.  Can I claim a lump sum even if the accident was my fault?

Yes. You are entitled to claim lump sum compensation for permanent impairment if you have some degree of impairment in accordance with WorkCover regulations.