What Is the WorkCover Process in Victoria?

The WorkCover process in Victoria can be difficult for workers to navigate on their own. If you have been injured on the job, you are entitled to benefits. Unfortunately, those who are new to the workers’ compensation system generally don’t know all of the benefits they deserve, as well as the steps they need to take to protect their rights.

Henry Carus + Associates have extensive experience with WorkCover claims. We can help you lodge a claim, review WorkCover’s decision, and fight for any benefits and additional entitlements you deserve.

If you need assistance with the WorkCover process in Victoria, call 03 9001 1318 today for a FREE, no-obligation consultation.

What Do I Need to Do After a Workplace Injury?

1. Report the Injury

The most important obligation workers have after being injured on the job is reporting the injury to their employer. If you don’t report the injury to your employer within 30 days, you may lose your right to WorkCover benefits.

2. Get Medical Care

You should also seek medical attention as soon as possible. A doctor or other qualified healthcare practitioner will assess your injuries. If you cannot work following an injury, you will be issued a Certificate of Capacity. This certificate enables you to claim weekly payments (i.e., wage loss benefits).

Read More: What Is a Certificate of Capacity in a WorkCover Claim?

3. Complete the Worker’s Injury Claim Form

The Worker’s Injury Claim Form can be downloaded from the WorkSafe Victoria website. You will need to complete parts 1–6, which request the following:

• Your personal information (including your name, address and contact details)
• Details about the incident that led to your injury
• Employment information
• Details about your earnings (e.g., the hours you worked prior to the accident, your hourly pre-tax wage, your weekly earnings, etc.)
• Information about the treatment you have received and your return to work (if applicable)
• The authority to release medical information; signing this section authorises doctors and medical practices involved in your treatment to provide information requested by WorkCover

All of the information you include in these sections needs to be as accurate as possible. If you have difficulties with the claim form, a knowledgeable lawyer can assist you.

Your employer will need to complete the remainder of the form, as well as submit a separate claim form to their WorkCover agent. The time limit for employers to complete this part of the process depends on whether the claim is for a mental injury or a physical injury, as well as the benefits being claimed.

Read More: Does WorkCover Pay for Employee Burnout?

What Happens Next?

WorkSafe generally has 28 days to make a decision whether to accept or reject a claim. (NOTE: Decisions about provisional payments, or benefits for work-related mental injuries, are made within 5 days.)

Before the decision is made, you should attend all doctor visits and follow recommendations for treatment and recovery. Your employer may also contact you about your work capacity and returning to work.

The next step in the WorkCover process in Victoria depends on whether your claim is accepted or rejected:

If Your Claim Is Accepted

You will receive a letter summarising the benefits you are due. These may include:

• Coverage of reasonable medical expenses for your work-related injury
• Provisional payments (first 13 weeks only)
• Weekly payments

Eligibility for weekly payments and the rate at which you are paid depend on your capacity for work. To continue receiving weekly payments, a revised Certificate of Capacity will need to be provided to WorkSafe every 28 days.

Read More: After an Approved Claim, What Will WorkCover Pay?

If your injuries have stabilised after 1 year post your injury date and it is determined that the work injury has resulted in permanent impairment, you may qualify for an impairment benefit. Permanent impairment is assessed by doctors who are specially trained Independent Impairment Assessors. Your injury must meet certain requirements for you to be eligible for the impairment benefit.

After 52 weeks of receiving weekly payments, you may also qualify for superannuation payments. Contributions are made to a super fund of your choice.

Your lawyer can also determine whether you have a claim for common law damages (see below).

If Your Claim Is Rejected

Claimants have the right to dispute any adverse WorkCover decision. Options for doing so include:

• Negotiating directly with the employer
• Requesting review of the decision by a WorkSafe agent
• Applying to the Workplace Injury Commission (formerly the Accident Compensation Conciliation Service) for a conciliation conference
• Requesting that the Workers’ Compensation Independent Review Service review the decision
• If medical issues are in dispute, seeking referral of the matter to a Medical Panel
• Disputing the decision in Court

Having a claim rejected is extremely stressful, and disputing a decision can be difficult for workers to handle alone. It is in your best interest to contact a lawyer who has experience handling disputes in the WorkCover process in Victoria.

Can I Bring a Common Law Claim Through WorkCover?

The process of filing a common law claim is different from the other aspects of WorkCover discussed above. Unlike WorkCover benefits—which are provided on a no-fault basis—common law damages are only available if it can be shown that the injury was caused by the negligence of an employer or another party. Your injury must also meet the definition of ‘serious’ followed by WorkSafe.

If you meet both of these criteria, you can claim common law damages. Common law damages you may be entitled to include:

• Loss of earnings
• Loss of future earning capacity
• Pain and suffering
• Loss of enjoyment of life

A lawyer can help you with the application process and review any compensation offers made by the insurer. If any disputes arise concerning fault, whether you have a serious injury, or the damages in your claim, it may be necessary to move to have the matter resolved in Court.

Read More: Can I Sue for a Work-Related Injury?

Get Help with the WorkCover Process in Victoria

Being injured at work can dramatically change your life. You may be in pain and have difficulty doing your job. In severe cases, your injuries may permanently alter your day-to-day life and your ability to work.

At Henry Carus + Associates, we believe You Deserve More. Our team is committed to helping you through the WorkCover process in Victoria and getting you all of the benefits and other compensation to which you are entitled.

Contact Henry Carus + Associates today for a FREE, no-obligation consultation. Our lawyers handle WorkCover claims on behalf of clients in Melbourne and throughout VIC.