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You may have a mental health WorkCover claim if you suffer a psychological injury connected to your work. Unfortunately, changes to the Victoria workers’ compensation scheme might make it more difficult for claims centring on mental health issues to be approved going forward.
The Victorian government has cited the rise of worker claims for mental health as a significant contributor to the deficit posted by WorkCover for the financial year. According to the state government, mental health claims could soon make up 50% of WorkCover’s costs (despite accounting for less than 20% of the claims workers lodge) if changes are not made.
At Henry Carus + Associates, we believe that workers are entitled to benefits if they suffer any kind of injury as a result of their work—physical, psychological, or both. Do not be discouraged by the headlines saying that WorkCover is ‘broken’; our lawyers can help with your mental health WorkCover claim and pursue the benefits and additional compensation you deserve.
Call 03 9001 1318 for a free, no-obligation consultation. Our WorkCover lawyers serve clients in Melbourne and throughout VIC.
Does WorkCover Accept Mental Health Claims?
The definition of an ‘injury’ used by WorkCover can be found in Victoria’s Workers Compensation Act 1958:
‘”injury” means any physical or mental injury’
– Workers’ Compensation Act 1958 S. 3(1)
An injury is considered compensable under WorkCover if the following condition is met:
‘If in any employment personal injury arising out of or in the course of the employment is caused to a worker his employer shall subject as hereinafter mentioned be liable to pay compensation…’
– Workers’ Compensation Act 1958 – Section 5
With all of this in mind, the answer is: Yes, WorkCover does accept claims for mental health if it can be shown that the condition arose out of in the course of your employment. This may consist of an incident in the workplace (such as being involved in or witnessing an accident), tasks or conditions on the job that adversely affect your mental health, and more.
A qualified lawyer can review your situation and determine whether you have a viable mental health WorkCover claim. Henry Carus + Associates can lodge and manage the claim on your behalf, and help to maximise your benefits.
Read More: How Do I File a WorkCover Claim?
What Conditions Are Covered by a Mental Health WorkCover Claim?
Safe Work Australia defines a mental or psychological injury as follows:
‘Psychological injury or mental injury includes a range of cognitive, emotional and behavioural symptoms that interfere with a worker’s life and can significantly affect how they feel, think, behave and interact with others.’
– Fact Sheet — Workers’ Compensation Legislation and Psychological Injury
Examples of mental health conditions that may arise as a result of or in the course of a worker’s employment include:
- Depression
- Anxiety
- Post-traumatic stress disorder
It is important to note that while job-related stress may include symptoms of anxiety or depression, stress related to your work by itself will generally not be considered sufficient to claim WorkCover. However, you may have a viable mental health WorkCover claim if you experience job burnout—which may involve significant physical as well as psychological symptoms.
Workplace bullying, harassment, abuse, and discrimination can also result in psychological injuries. If you have been the victim of violence or other wrongful conduct in the workplace, you should seek legal counsel promptly.
What Psychological Injuries Are Not Covered?
The cause of a work-related mental injury can affect a worker’s entitlement to benefits. Workers are not entitled to benefits or additional compensation if mental health issues arise as a result of the following:
- ‘management action taken on reasonable grounds and in a reasonable manner by or on behalf of the worker’s employer’,
- ‘a decision of the worker’s employer, on reasonable grounds, to take or not to take any management action’, or
- ‘any expectation by the worker that any management action would, or would not, be taken or a decision made to take or not to take, any management action’.
– WorkSafe Victoria Claims Manual 2.1.2 Exceptions to entitlement for mental injuries
Although the ‘reasonable management action defence’ provides broad exceptions to WorkCover entitlement, such arguments are not unassailable. You should speak to a WorkCover lawyer immediately if your claim has been rejected on this basis.
What Benefits Are Available for Mental Health?
Starting in 2021, WorkCover began providing a benefit specifically for workers with mental injuries. Known as provisional payments, the benefit helps to pay for treatment of a mental injury (such as psychotherapy or counselling). You are eligible for provisional payments as soon as your claim is lodged. The benefit is paid for up to 13 weeks—even if your claim is later rejected.
Additional benefits you may be entitled to if your WorkCover claim is accepted include:
- Medical treatment expenses, such as appointments with GPs, psychologists and psychiatrists, and other services
- Weekly payments if your ability to work is impacted
- You will need to undergo a medical assessment and be issued a Certificate of Capacity to qualify for weekly payments
- Return to work support, if applicable
- Lump sum permanent impairment benefit
- A doctor will perform a specialised impairment assessment to determine the level of permanent impairment and whether you meet the threshold for lump-sum compensation
- Superannuation contributions, if you receive weekly payments for 52 weeks or more
You may also have a claim for common law damages if it can be shown that:
- The psychological injury was caused by an employer, coworker, or other party.
AND - The worker has suffered a ‘serious injury’ as defined by WorkSafe.
Claims for damages should be handled by a qualified legal professional. Our lawyers have the experience and knowledge to ensure that there is strong medical documentation and other evidence needed to prove your entitlement to common law compensation.
Do I Have a Mental Health WorkCover Claim?
The pending changes to the workers’ compensation scheme in Victoria could make it more difficult for workers to get the benefits they deserve—especially for mental health issues. Henry Carus + Associates have unparalleled understanding of workers’ compensation legislation. We are closely following the proposed changes so we can provide uninterrupted, high-quality legal service to our clients.
Do not hesitate to contact our firm for a FREE, no-obligation consultation as soon as possible if your mental health has suffered due to your employment. We will fight to maximise your benefits and any additional damages so you can get the care you need and the full compensation you deserve.
