The Employee’s Guide to the Workers’ Compensation Claim Process in Victoria

workers accidents in Victoria

Accidents and illnesses that occur in the workplace can be stressful, and the subsequent process may seem quite daunting and uncertain to many. If you’re an employee who’s suffered an accident at work that caused you serious injury or illness, you can seek compensation by submitting a workers’ compensation claim to your employer. This article will look at Victoria’s workers’ compensation claim process in detail, so you know what rights are available to you at work.

If you’re an employee who’s suffered a work-related injury or illness, you should ensure you do the following to seek compensation:

  • Get a Certificate of Capacity
    If you want to make a compensation claim for treatment costs or loss of income (i.e. weekly payments), you’ll have to give your employer a signed Certificate of Capacity issued by a medical practitioner. You can choose your preferred doctor or healthcare provider to help with this step
  • If a motor vehicle was involved, report the accident to police
    If your injury was a result of a motor vehicle accident, this should also be reported to the police
  • Complete the Worker’s Injury Claim Form
    List down all injuries or illnesses related to your claim for compensation. Henry Carus + Associates  Lawyers have a guide to what illnesses are and aren’t covered by workers’ compensation
  • Give the claim form to your employer
    You can do this in person or via mail. Your employer will have to complete the Employer Lodgement Details section of the form, provide you with a copy, and submit it to their WorkSafe Agent within ten days
  • If required, attend an independent medical examination
    A medical examination will offer impartial information that will aid the WorkSafe Agent in determining your entitlement to compensation for loss of income, treatment costs, etc.
  • Give a statement detailing the accident
    If a Circumstance Investigator has been appointed to obtain information and witness statements regarding your claimed injury, this is the best time to give the WorkSafe Agent details about the accident and your injury
  • Expect to receive a decision within 28 days
    The WorkSafe Agent will write to you with their decision within 28 days from receiving the claim from your employer
  • Talk to your employer about returning to work
    Tell your employer if you need help in making your return to work safer, e.g. modifying your duties or work area, or reducing your hours.

If your claim has been accepted, you should do the following:

Keep sending Certificates of Capacity to your employer
If you require more time off work, modified duties, or reduced hours after the first two weeks, you will need extra signed certificates to continue receiving weekly payments. These can be issued by an approved medical practitioner.

Get approval before you access certain treatments
Some treatments need approval from your employer or the WorkSafe Agent before you may access them.

Send your treatment invoices/receipts to your employer and WorkSafe Agent
First to your employer, then to your WorkSafe Agent. Your employer has to pay an excess before the WorkSafe Agent takes over the costs of treatment. Send your receipts to the WorkPlace Agent after you have been informed that your employer has paid the excess.

Ask your healthcare providers to invoice the WorkSafe Agent directly
This process is preferred by WorkSafe, and they’ll only pay for the approved cost of treatment. You should also complete an Electronic Funds Transfer Application Form so the agent can deposit funds directly into your nominated account.

For more information on how much you’re entitled to in workers’ compensation, or which treatments require pre-approval, contact Henry Carus + Associates for further guidance.

If your claim has been rejected, you can still do the following to appeal the decision:

  • Request the WorkSafe Agent to review their decision
    The review will be made by a senior person at the WorkSafe agency who wasn’t involved in the original decision. If you’re still unhappy with the decision made by the WorkSafe Agent, you can take the matter to the Accident Compensation Conciliation Service
  • Take the matter to the Accident Compensation Conciliation Service (ACCS)
    The ACCS is a free independent service provided by the Victorian Government to help resolve claim disputes. All parties may refer the dispute for conciliation by a conciliation officer within 60 days of notice of the decision. Legal representation is only allowed before a conciliation officer if it is agreed to by all parties. Medical questions should be referred to a medical panel for decision. If your dispute still can’t be solved through the ACCS, you can take the matter to court.
  • Take the matter to court
    The conciliation officer will need to issue a certificate before the matter can be taken to court. The court will only determine questions of law for the claim – including liability for the injury and any benefit – while a referral to a medical panel may still occur to deal with any medical questions (from which there will be no appeal). To help you win the case, it’s definitely advised to seek the help of a specialist personal injury lawyer to get you the compensation you deserve.
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