Employers in New South Wales are legally obliged to take out workers compensation insurance.  If you are injured at work or suffer a work induced illness and you have a reduced work capacity, then you can claim workers compensation through your employer’s insurance company.

There are extremely strict time limits when applying for worker compensation claim, so the rule of thumb is that everything should be done as quickly as possible.

Types of injuries

You can make worker compensation claims for major and well as minor injuries.  You may also be able to claim compensation for certain psychiatric conditions brought on at work, for example, as a result of bullying or from witnessing a traumatic event at work.  You may also be able to claim for injuries sustained during your lunch hour or when travelling for work.

Who can claim?

You need to be a worker or a deemed worker to be eligible to claim workers compensation.  If you receive wages or a commission each week, then you are a worker.  A deemed worker can include casual or part time workers, outworkers and contractors.For steps to make a WorkCover claim, please click here.

Types of compensation

There are a number of different types of compensation you can claim for costs related to a work place injury or illness, including:

  • weekly payments; to cover your loss of earnings;
  • medical and other expenses, subject to the prior approval of your employer’s insurer. Some medical expenses are exempt from prior approval;
  • rehabilitation expenses;
  • other reasonable expenses, such as for special equipment; and
  • payment for permanent impairment, which may be a lump sum.

Notification

If you have had an injury at work, notify your employer as soon as possible and have the details recorded on the employer’s register of injuries.  If your employer does not have a register of injuries, make sure that they create one in order to record your injury.  It is important that you keep a copy of that entry for your records.

At this stage, if the injury is a major one, we recommend that you get legal advice immediately in order to ensure that you go through process to claim compensation in a way that optimises your chances of getting the best possible outcome.

Seeing the doctor

You always have the right to see professionals of your own choosing including your own doctor, usually your GP.  You should see your own doctor to arrange treatment as soon as possible after your injury.  We recommend that you see your own doctor even if one is recommended to you by your employer.  Where the worker compensation claim is disputed, the insurance company may require you to see one of their own doctors for assessment.  We recommend that you obtain legal advice before agreeing to an assessment by a doctor on behalf of an insurance company.

Medical Certificate

Your doctor will provide you with a medical certificate, known as a WorkCover NSW certificate of capacity (Certificate).

You will be asked to sign the declaration attached to the Certificate.  This declaration authorises your doctor to provide relevant information about your injury or illness to your employer and the insurer.   The Certificate will not be valid without a signed declaration. You need a valid Certificate to make any worker compensation claims.  Generally, if you are impaired for a long period of time, you must obtain a Certificate from your doctor every 28 days to help determine your capacity and tailor the plan to manage your injury and help you back to work.

Claim Form

Once you have a valid Certificate and have attached any necessary receipts and bills, a compensation claim form can then be prepared and lodged with your employer’s insurers. For minor injuries, you can do this yourself by getting the workers compensation claim form directly from your employer.

For major injuries, we recommend that you get legal advice and have your legal advisers prepare and lodge the worker compensation claim form for you.  Your employer’s insurer may ask for further information.  You are obliged to provide the requested information within seven days of being asked for it.  For minor injuries, you can do this yourself.  For major injuries, we recommend that you immediately refer all such requests to your legal advisers.

If the insurer agrees to your costs claim, you have reported everything within the time limits and attached all the necessary documents to your claims form, then your compensation claim should be processed very quickly.

Disputes

If the insurance company’s doctor assesses you as less impaired than your own doctor, and you do not agree to a reduced claim based on the insurance company doctor’s assessment, then we recommend that you get legal advice to help you navigate your dispute.

Do not allow the insurance company to send you to multiple doctors to be assessed before you get legal advice.  Generally, insurance companies will do this if they do not like the assessment made by the first doctor – likely an assessment favourable to you.

Can my employer fire me?

Your employer must not dismiss you because of your workplace injury or illness during the first six months after your injury or illness.  If your employer tries to dismiss you within that time, we recommend getting legal advice.

Claims for negligence

If your injuries were a result of negligence, you may be able to get further compensation.  Your legal advisers can help you determine whether this is a possibility.

Next steps

If you have been injured or developed an illness that you believe may be as a result of your work, then you need to report it to your employer immediately.  Even if you think it is a minor injury, you should go to a doctor that you trust to be assessed to understand the full extent of your injury.  For very minor injuries, you may be able to handle the claim yourself.  However, we recommend that for major injuries, you obtain legal advice.  Owen Hodge Lawyers would be happy to help you navigate your way through a workers compensation claim to ensure the best outcome for you and your family. Call us at 1800 770 780 or contact us via ohl@owenhodge.com.au to schedule a consultation with our experienced personal injury lawyers.