Tips for providing a statement to a WorkCover Circumstance Investigator

providing a workcover statement

You are injured at work. You get medical attention, notify your employer, and lodge a WorkCover claim form. But what happens next?

For relatively straightforward matters, usually the WorkCover Authorised Insurer (the ‘Agent’) will review the information detailed in the claim form and communicate with your employer to confirm what has occurred. With any luck, someone will have completed an incident report or register of injuries, and the claim can be easily accepted within the time permitted by the legislation. But what if the circumstances of the injury are not so straightforward? One such example our firm sees often, is an injury which has occurred over the course of a worker’s employment. This is common for back, knee and shoulder injuries, where a worker has been performing repetitive duties over an extended period of time.

In circumstances such as these, the questions asked in the WorkCover claim form do not properly address all of the relevant facts surrounding an injury, to enable the Agent to determine liability. In order to do so, the Agent must conduct their own investigations, which is often done with a ‘WorkCover Circumstance Investigator’. If a WorkCover Circumstance Investigator has requested you give a statement, this has occurred because the Agent requires further information to assist in the determination of liability (and/or other aspects of your claim). The insurer has a responsibility to provide benefits only to those that are properly covered by the WorkCover scheme. Sometimes the way the information is given may lead to a denial of the claim, where if all the relevant information is given, the claim would be accepted.

We have recently seen this happen to an injured worker who thought that they had suffered a temporary strain which would resolve. Over time the injury did not heal and continued to deteriorate. A WorkCover claim form was lodged and a statement provided. However due to the length of time which had elapsed since the initial incident the precise date of injury was incorrectly identified. When the date of injury in the statement failed to corroborate with the date of injury in the WorkCover claim form, the Agent denied the claim leaving the worker without their statutory entitlements.

This example highlights how important it is the get the information correct on any statement given. So, while we believe an injured worker in general should assist with giving a statement, we ask that the statement be reviewed by us to help ensure it is accurate.

A small mistake like getting a date wrong can be so difficult for an injured worker who then has to try to survive without benefits until the mistake is all sorted out.

So our simple suggestions would be to any injured worker asked to give a statement:

  • Remember you are not required to give a statement and you are doing so to help the Insurer
  • You should never sign a statement which is not in your own words, truthful and accurate
  • If aspects of the statement written by the investigator do not seem right to you, ask that they be changed or removed
  • If you are troubled or feeling unsure about the whole process, find a personal injury firm that can give you guidance

Remember, firms like Henry Carus + Associates can work for you without charge until you are successful with a compensation claim and have the specialist knowledge to guide you at the start, knowing what will be helpful to your claim all the way to the end.

WorkCover

Originally published on