FIGHT BACK THROUGH MAURICE BLACKBURN When you’ve been hurt, injured or suffered loss, it’s easy to feel powerless in the face of big organisations and big legal teams. But you shouldn’t have to suffer because of it. You fight back, and you do it through us. Maurice Blackburn was born from one man’s belief in making a difference to people’s lives. Nearly 100 years on these values remain a powerful influence on everything we do. We exist to help everyday Australians fight back against unfair treatment. And we’ll fight for what you need to get on with life. Because at Maurice Blackburn, we fight for fair.
If you suffer from an injury, illness or disease arising out of, or in the course of employment, you can claim compensation from WorkSafe. Accessing your WorkCover entitlements can be a very complicated process. If you are injured, you should seek advice from your Union or Maurice Blackburn to guide you through the WorkCover claims process. WorkCover covers injured workers, including part-time workers, casual workers and in many circumstances subcontractors, such as owner/drivers and agency nurses. You can claim compensation for the aggravation, acceleration, exacerbation, deterioration or recurrence of injuries, illnesses or disease provided employment is a significant contributing factor. Injuries including cancers, strokes, asthma, heart conditions and degenerative conditions are often aggravated or exacerbated by employment. Injuries suffered during normal recesses, such as morning or afternoon tea-breaks, are covered in most circumstances. As long as you can show some relationship between your employment and the injury, you may be able to claim compensation. Contact Maurice Blackburn or your Union for further advice.
HOW DO I CLAIM COMPENSATION? TO CLAIM COMPENSATION, YOU SHOULD: 1 Report your injury to your employer within 30 days. Failure to do so may result in your right to claim compensation being lost. 2 Complete a WorkCover claim form. This is a standard form available from your employer, your Union, a post office, WorkSafe or Maurice Blackburn. 3 Get a WorkCover medical certificate if you need time off work. The medical certificate is not required if you are only claiming for medical expenses. Keep a copy of the claim form and medical certificate. Give the originals to your employer as soon as possible. Make sure your employer signs and dates the form on the day it was received. You should also lodge a copy of the claim form with WorkSafe. Your employer must pass the claim on to its Insurer within 10 days. The Insurer must make a decision to accept or reject your claim within 28 days. If no decision is made within 28 days, your claim is deemed to have been accepted. You may be asked to attend a doctorâ€™s appointment by the Insurer and you must comply with that request. You do not have to talk to investigators appointed by WorkSafe.
WEEKLY PAYMENT CLAIMS (MADE ON OR AFTER 5 APRIL 2010) 0-13 weeks (first 13 weeks of payments)
14-130 weeks (up to 130 weeks of payment)
Current work capacity
The difference between 95% of PIAWE* and worker’s current weekly earnings; or the difference between twice the State average weekly earnings ($2,050) and the worker’s current weekly earnings (whichever is the lesser).
The difference between 80% PIAWE and 80% of current weekly earnings; or the difference between twice the State average weekly earnings ($2,050) and 80% of the worker’s current weekly earnings, whichever is the lesser.
No current work capacity
95% of PIAWE*
80% of PIAWE or twice the State average weekly earnings ($2,050) whichever is the lesser.
WHAT ARE MY WEEKLY PAYMENTS? Weekly payments are paid as a percentage of your pre injury average weekly earnings (PIAWE). PIAWE are calculated on an average of your gross pay and includes your regular overtime and shift allowance for the first twelve months only. The maximum rate for weekly payments is twice the State average weekly earnings (presently $2,050). In addition to weekly payments of compensation, you may also be paid accident make-up pay in accordance with your industrial award or EBA. The period of makeup pay can vary and you should check your entitlement with your Union. If you are in receipt of weekly payments for more than 52 weeks (whether consecutive or not) the insurer must pay superannuation based on your weekly payment. Your weekly payments can be suspended or terminated if you do not make every reasonable effort to participate with rehabilitation, retraining and return to
work plans. Return to work plans should be in writing and must be formed in consultation with your treating doctor (although only with the worker’s consent) and a rehabilitation services provider. Your employer has an obligation to provide suitable employment for up to 52 weeks. If you have a capacity for modified work and your employer fails to offer work then your weekly payments will continue.
WHAT MEDICAL EXPENSES ARE PAYABLE? WorkSafe will pay all reasonable medical, hospital, nursing, personal and household, occupational, rehabilitation and ambulance services. Expenses, such as doctors, chemists, physiotherapy and chiropractic bills, are also covered. In addition, attendant care, modifications to a home or car, home help and transportation costs can be paid, providing they are approved by WorkSafe. Payment of medical expenses continues while you are on weekly payments and for at least 52 weeks after your right to weekly payments ceases, and longer in most cases.
More than 130 weeks
Worker must be: (i) working more than 15 hours per week; and (ii) earning more than $177 gross per week; and (iii) be indefinitely incapable of further or additional employment to receive the difference between 80% PIAWE and 80% of current weekly earnings; or the difference between twice the State average weekly earnings ($2,050) and 80% of the worker’s current weekly earnings, whichever is the lesser. Worker must have: (i) no current capacity for work; and (ii) be likely to continue indefinitely to have no current capacity for work to receive 80% PIAWE or twice the State average weekly earnings (whichever is the lesser).
WHAT DO I DO IF MY CLAIM IS REJECTED OR MY PAYMENTS ARE REDUCED OR STOPPED? In most instances, WorkSafe or the SelfInsurer will provide a notice in writing of its intention to either reject, stop or reduce your payments of compensation. The notice should provide the reasons for a decision. If you disagree with the decision, you may make a request for conciliation with the Accident Compensation Conciliation Service. Most disputes regarding weekly payments or medical expenses must first go through conciliation. You do not have to accept the decision made by WorkSafe or the Self-Insurer’s. If you wish to dispute a decision, you should contact your Union or Maurice Blackburn for advice. Generally if you wish to dispute a decision, you must do so within 60 days of receiving the notice.
CONCILIATION Conciliation is an informal procedure where you, the employer and WorkSafe get together to try to reach agreement over the dispute. Your Union will be able to assist you at conciliation. Do not enter into any agreement at conciliation without obtaining advice. If an offer is made to you, contact your Union or Maurice Blackburn. If a conciliator is satisfied that all reasonable steps have been taken to settle the dispute a certificate of genuine dispute will be issued. If you are not happy with the conciliation outcome, you can proceed to Court after the certificate has been issued. You should contact Maurice Blackburn for advice.
MEDICAL EXAMINATIONS – DO I HAVE TO ATTEND? You are required to attend reasonable medical examinations arranged by WorkSafe or the Self-Insurer and, in some circumstances, your employer. Failure to attend medical examinations can result in your weekly payments being suspended or terminated.
LUMP SUM CLAIMS
SECTION 98C Physical impairment 1/7/08– 30/6/09
80% $396,700 $409,200
$527,610 $543,920 $555,350
Psychiatric impairment (claims made on or after 10 December 2009) 30%
You can claim a lump sum for permanent impairment. Generally, a claim cannot be made within 12 months of the injury and not before the injury is stable. The lump sum amount will depend upon your impairment level and date of injury. The maximum payable is $555,350.
CAN I SUE?
80% $503,000 $503,000
$527,610 $543,920 $555,350
MODIFIED WHOLE PERSON IMPAIRMENT TABLE Table A: Impairments to back, neck, arm/hand or leg/foot sustained on or after 3 December 2003
If your injuries are due to the fault of your employer or any other person, you may be entitled to bring a common law claim seeking a further lump sum. You have six years from the date of your injury in which to commence a common law claim. You can claim up to a maximum of $1,275,570 for loss of earnings and $555,350 for pain and suffering. If you believe your injuries are due to your employer’s or some other person’s fault then you should seek advice from Maurice Blackburn.
If a worker dies as a result of a work-related injury, illness or disease, the dependants of the worker are able to claim compensation.
Table B: Claims for impairments to back, neck or spine made on or after 10 December 2009 1/7/08– 30/6/09
A lump sum of up to $555,350 plus a pension may be payable, plus reasonable funeral and medical expenses. If the death is due to the fault of the employer or any other person a dependant may also be entitled to bring a common law claim seeking a further lump sum payment.
FAQS ABOUT WORKCOVER AFTER THE ACCIDENT There is no specific time limit for claiming medical expenses only; however we would recommend that you refer the claim to the Accident Compensation Conciliation Service if WorkSafe fails to make a decision within 28 days. If your claim is accepted by WorkSafe, you will have to repay any Centrelink benefits you may have received. If your claim is accepted by WorkSafe, you will be entitled to have your sick or annual leave recredited.
YOU SHOULD KNOW You are entitled to treatment from a doctor of your choice. You do not have to be treated at a public hospital or by a work doctor if you donâ€™t want to. WorkSafe must pay the reasonable costs of travelling for purposes of receiving medical treatment or rehabilitation. If you are claiming taxi expenses, they should be approved by WorkSafe first. If you use your car you should record the kilometres travelled and submit the details to WorkSafe for payment. You should keep a record of all attempts to return to work or retraining. This will be useful in protecting your rights. You should keep a general diary of the impact the injury has on your social and family activities, and ability to participate in any sporting activities and hobbies.
to consider your request. If a decision is not made within that time, you may refer the matter to Conciliation. You should ensure the details on the reverse side of the medical certificate are complete and accurate otherwise WorkSafe will not pay your weekly payments. If you are in receipt of weekly payments and intend to be away interstate or overseas for longer than 28 days, special permission must be obtained from WorkSafe for an extended certificate. If your employer closes down, your WorkCover entitlements will not be affected. In some circumstances, you may become a direct payee of WorkSafe. Weekly payments must be paid within seven days, and in accordance with your usual pay period. If this does not occur you should refer the matter to Conciliation. If you receive a superannuation lump sum it will suspend your weekly payments unless you roll it over into an approved fund. However, you are entitled to receive a redundancy or severance lump sum.
PROTECTING YOUR RIGHTS IS OUR BUSINESS At Maurice Blackburn, we are committed to getting a fair outcome for our clients so you can get on with your life without disadvantage.
WorkSafe must provide you with copies of any medical reports obtained in your claim if you request access to them under the Accident Compensation Act and/or Freedom of Information Act.
Our expert WorkCover lawyers provide a free first consultation and will fight to ensure you receive the best possible outcome. We recognise that the compensation you receive is vital to ensuring quality of life for you and your family. If you would like to make an appointment please call 1800 810 812.
Sometimes WorkSafe does not respond promptly to requests for treatment, surgery or services such as home help. Generally, 28 days is a reasonable period
FROM THE VERY BEGINNING, WE FOUGHT FOR THE RIGHTS OF ORDINARY PEOPLE. WE CONTINUE THIS TRADITION TODAY.
1800 810 812 wefightforfair.com.au WORKCOVER
ROAD ACCIDENT INJURIES
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Dandenong (03) 9794 0403 Suite 3 314-326 Thomas St Dandenong VIC 3175 Frankston (03) 9784 6100 Shop 3 428 Nepean Hwy Frankston VIC 3199 Geelong (03) 5221 1152 120 Yarra St Geelong VIC 3220
Greensborough (03) 9431 7500 85 Grimshaw St Greensborough VIC 3088
Sunshine (03) 9310 2966 225 Hampshire Rd Sunshine VIC 3020
Mildura (03) 5018 4000 159 Lime Ave Mildura VIC 3502
Traralgon (03) 5174 8633 Level 1 7 Princes Hwy Traralgon VIC 3844
Reservoir (03) 9462 2608 301 Spring St Reservoir VIC 3073 Ringwood (03) 9876 8555 41–43 Ringwood St Ringwood VIC 3134
Wangaratta (03) 5720 1500 29 Ely St Wangaratta VIC 3677
VISITING OFFICES – FREECALL 1800 810 812 Bairnsdale Ballarat Bendigo Box Hill Broadmeadows Cranbourne
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Oakleigh Pakenham Rosebud Sale Shepparton Swan Hill
Sunbury Warragul Warrnambool Werribee Wodonga
Offices also in QLD, NSW, ACT & WA
Quality ISO 9001
Maurice Blackburn is a leading Australian law firm certified to the international ISO 9001:2008 quality standard. Information correct at 1 July 2013. This brochure is a general guide to dealing with WorkCover claims and is not a substitute for professional advice in this area. Maurice Blackburn is proud to be carbon neutral (see our website for details). This brochure is printed on ecoStar Silk. Made with 100% certified post consumer waste fibre, it is produced with a carbon neutral manufacturing process and has been made in a facility that operates under the ISO 14001 Environmental Management System. MB4184_VICWC 10/13