How Do I File a WorkCover Claim?

How to Lodge a WorkCover Claim

You work hard to provide for your family. If you are injured on the job, you have the right to benefits for your medical costs and lost wages, as well as other support.

Unfortunately, many workers struggle with the process of filing a WorkCover claim. These struggles often result in late or unpaid benefits, delayed or denied medical treatments, and immense frustration and heartache for injured workers and their families.

If you were hurt at work, it is in your best interest to speak to a workers’ compensation lawyer about your claim. Keep reading for an overview of the WorkCover claims process, or call Henry Carus + Associates at 03 9001 1318 for a free, no-obligation consultation to discuss your WorkCover claim.

Getting Started on Your WorkCover Claim

After getting hurt at work, your first priority is to seek medical care. Your WorkCover benefits should retroactively cover the cost of treatments you receive before you are able to lodge a claim.

Next, you need to report the injury to your employer in writing no more than 30 days after the accident. You may lose the right to WorkCover benefits if you fail to notify your employer within this timeframe.

The next step is to lodge a WorkCover claim for compensation. You will need to complete and submit the worker’s injury claim form to your employer. Your employer then has 10 days to submit your claim and other documents to its WorkSafe agent.

Claiming Your WorkCover Benefits

The WorkSafe agent will review your claim and other documents submitted by your employer. Within 28 days, the agent will determine the payments to which you are entitled.

You may receive compensation for medical expenses, wage loss, or both. Additional benefits may be available if you suffer a permanent impairment.

Medical Expenses

To be fairly compensated for treatment expenses related to your work injury, it is important to provide all of the requested information to WorkSafe. This includes:

  • The injury or condition you have suffered
  • The workplace incident that caused your injury
  • What job duties you were performing at the time
  • Where at your workplace the incident occurred
  • When the work injury occurred
  • Where you have received treatment for your injuries
  • When/if you have returned to work, as well as the hours you are working and the tasks you are performing

If your workplace injury was the result of a motor vehicle accident, you must also include information on the vehicles involved and the police station that took the accident report.

Wage Loss Replacement

You may be entitled to compensation for a portion of the income you lose as a result of your injury. These benefits are known as weekly payments for time lost from work. The amount you receive each week is based on your average weekly earnings before the injury.

The worker’s injury claim form includes a section workers must complete in order to claim these benefits. Requested information in this section includes:

  • The number of standard hours you worked in a week before getting injured
  • The hours you usually worked
  • Your usual pre-tax hourly pay rate
  • Your weekly earnings before tax
  • Weekly overtime or shift work

You need a Certificate of Capacity in order to receive weekly payments for time lost from work. The certificate describes your injury and the limits it places on your ability to work. A medical practitioner must issue the initial Certificate of Capacity, while additional certificates can be issued by a medical practitioner or a physiotherapist, an osteopath, or a chiropractor.

If you receive weekly payments for time lost from work for more than 52 weeks, you may be eligible for superannuation contributions on those payments. This entitlement is designed to make up for the super payments you miss as a result of being unable to work. When you reach retirement age, you will not have missed out on making much-needed contributions to your fund.

Once the 52 weeks have elapsed, you will need to complete the choice of superannuation fund form and provide it to your WorkSafe agent. To maximise the contributions to your super fund, you must take action within three months of becoming eligible.

Permanent Impairment Benefit

If your workplace injury results in permanent physical or psychological impairment, you may be entitled to a permanent impairment benefit. This benefit is paid one time via a lump sum (i.e., all at once, rather than through weekly payments).

The impairment assessment cannot take place until your condition has stabilised. Generally, you cannot lodge the impairment benefit claim until 12 months after your injury occurred.

The steps of making a claim for a permanent impairment benefit are:

  1. Completing the worker’s claim for impairment benefits form
  2. Lodging the claim with your employer
  3. Submitting your claim directly to WorkSafe (if your employer is no longer in business or fails to complete the claim form within 10 days)

After your condition is stable and you decide to lodge an impairment benefit claim, you will need to submit to an Impairment Assessment. Assessments are performed by doctors who have special training in the evaluation of permanent injuries.

If your injury meets certain minimum thresholds for permanent impairment, you may be entitled to a lump sum benefit payment.

Do I Need a Lawyer for My WorkCover Claim?

As you can see, lodging a WorkCover claim is not easy. You may need to complete multiple forms that use complex legal terminology, see multiple doctors for evaluation of your injuries, and endure sometimes interminable waiting to learn if you qualify for benefits.

Given the hardships of the WorkCover claims process, it is in your best interest to contact a work injury lawyer as soon as possible. Some of the ways an experienced workers’ compensation lawyer can help with your claim include:

  • Helping you complete any and all claim forms
  • Advising you how to obtain the Certificate of Capacity
  • Reviewing WorkSafe’s decision on your claim
  • Disputing the rejection of your WorkCover claim or underpayment of benefits – a lawyer can discuss your options, including:
    • Requesting review of your claim by a senior WorkSafe agent
    • Conciliation of your claim through the Accident Compensation Conciliation Service
    • Referral of your claim to a medical panel
    • Taking your dispute before the Magistrates’ Court or the County Court

If the negligence of your employer or another party was a factor in your workplace injury, you may be able to recover compensation through a common-law personal injury claim. Your lawyer can advise you how to proceed with this type of claim, which is separate from the WorkCover claim.

The viability of your common law claim is dependent in part on your ability to prove that you have a serious injury. Your lawyer can advise you how to apply for a serious injury certificate through the Victoria WorkCover Authority.

Get Help with Your WorkCover Claim Today

Henry Carus + Associates has unrivalled experience and success helping injured workers get the benefits and compensation they deserve. Our team understands the complexities of WorkCover claims, as well as the physical and emotional toll the process can take.

We handle your WorkCover claim on a No Win – No Fee basis. There are no upfront costs, and you pay Henry Carus + Associates nothing if we are unable to recover in your claim.

If you have been injured on the job, don’t wait to get qualified assistance with your WorkCover claim. Call Henry Carus + Associates at 03 9001 1318 today for a free, no-obligation consultation. Our workers’ compensation lawyers serve clients in Melbourne and throughout VIC.

Leave a Reply