Workers Compensation

While we should all be thankful that Australian states each have a workers’ compensation scheme to cover those injured on their way to or from, or while at, their workplace, the complexity of the schemes means you almost certainly need some expert legal guidance if you unfortunately find yourself in need of such compensation.

This is no different in NSW, where a number of legislative changes to the Workers Compensation Act 1987 and other regulatory changes in the intervening years have created a fairly complex system, both when it comes to making a claim and also in terms of how your claim is assessed.

If you’re injured at work there are a number of ways you can claim compensation. Depending on the seriousness of the injury and the time you need to take off work, weekly workers’ compensation payments can be paid to you. You can also be entitled to reimbursement of medical expenses, loss-of-income payments in case you are unable to work because of the injury, and payment of a lump sum amount for any permanent injury.

When it comes to permanent injury, a common question asked by people is how this is assessed, which is the primary subject of this article.

Assessing a permanent injury

A permanent injury is understood as one which has stabilised and resulted in ongoing impairment that is unlikely to change within the next 12 months, meaning the injured person has reached what is called ‘Maximum Medical Improvement’ (MMI). It can refer to the impairment of both the physical and/or mental ability of an injured worker.

The degree of permanent impairment that results from an injury is assessed by reference to the NSW Workers Compensation Guidelines which compliments the American Medical Association Guides for the Evaluation of Permanent Impairment. Detailed tables and methods are used for evaluating the percentage of the injured person’s ‘whole person impairment’ (WPI), considering all the injuries by reference to pathology sustained in the accident.

A medical specialist trained in assessing impairment using the guidelines must conduct the assessment of an injured person as they present on the day, taking account of their relevant medical history and all available relevant medical information to determine:

• whether the condition has reached MMI;
• whether the claimant’s compensable injury/condition has resulted in an impairment;
• whether the impairment is permanent;
• the degree of permanent impairment that results from the injury;
• the proportion of permanent impairment due to any previous injury, pre-existing condition or abnormality.

The assessor must exercise their clinical judgement in making a diagnosis of permanent impairment and make deductions for any pre-existing injuries/conditions. They must then make clear the degree of impairment that results from the compensable injury/condition. Any deductions for pre-existing injuries/conditions are also to be clearly identified and calculated. If a related injury/condition had not previously been identified, its nature should be recorded in the report and any connection to the relevant compensable injury or medical condition specified.

Impairments arising from the same injury are to be assessed together. If there are impairments resulting from more than one injury sustained in the work accident, these are to be assessed together to calculate the degree of permanent impairment of the claimant.

There is an exception in the case of psychiatric or psychological injuries. Any impairments resulting from a psychological and/or psychiatric injury are to be assessed separately from the degree of impairment caused by physical injuries arising out of the same incident. The results of the two assessments cannot be combined. Impairment for secondary psychological injuries (conditions caused by for example, pain from physical injuries) are non-compensable.

The importance of timing and time limits

In NSW, the time limit to make a workers’ compensation claim is generally six months from the date of your injury or accident. You can still make a claim after this period but will need to show ignorance, mistake or absence from the State where you are making the claim as a reason/s for the late claim. A claim for injuries resulting in death or serious permanent impairment may be made within three years from the date of the injury or death.

It should be noted that the Workers Compensation Act allows an injured worker to only make one claim for permanent impairment compensation that results from any injury. After that, you can’t return and claim an increase in lump sum compensation, unless your condition deteriorates in the future.

This means the timing and assessment of a lump sum claim for WPI is very important. If you make such a claim too soon after the work incident and your WPI assessment is, for example, less than 10%, you will not receive any lump sum compensation and weekly payments will be limited to a maximum of five years and medical expenses for two years thereafter.

In NSW your date of injury (“DOI”) is also important. Different legislation applies depending on whether your injury was before or after 19 June 2012. Expert legal advice should definitely be sought if you’re unsure about which laws apply to your work injury.

Negligence and common law claims

If you believe your work injury was the result of negligence on behalf of your employer or workplace, you may also have a claim for damages through a common law claim, including for future and past economic loss (such as wages and superannuation).

Your assessment for WPI does affect, however, your ability to make a claim for negligence against an employer, in that you can only make such a claim if your WPI is assessed as 15% or greater.

The importance of legal advice

If your workplace injury results in permanent impairment, the workers’ compensation insurer may offer a lump sum amount against your compensation claim. This offer should only be considered after seeking advice from an experienced legal representative such as BPC Lawyers. This is because your response may prevent you later pursuing your common law right to claim damages from the injury, which potentially may be far larger than the lump sum on offer.

At BPC Lawyers, we offer a team of experienced workers’ compensation lawyers who have won multiple industry awards. We can explain whether your injury falls under Common Law or WorkCover and help you achieve the best outcome possible. Contact us today (02) 8280 6900 for a free initial legal consultation.

The details are scarce, but there are plenty of stories. A quick Internet search reveals that there were two highly-publicised forklift accidents in the Sydney area last year. One of them happened at a Banksmeadow business on November 29. The other happened at a Condell Park warehouse on May 11. Both were fatal, according to media reports.

Sadly, these were not isolated incidents. Between July 2014 and July 2016, for example, more than 1,300 workers were injured in forklift incidents. Three of the workers involved did not survive. Then, in 2017, SafeWork NSW prosecuted and issued fines to four NSW businesses totaling more than $830,000 “for incidents where workers were injured or killed by a forklift”.

In light of that, here’s what you need to know about how to avoid getting hurt in a work-related forklift accident and the actions to take if you are injured.

Know the basics

According to SafeWork NSW, a forklift or industrial lift truck is generally defined as a vehicle used to “used to lift, stack and transfer loads”. As such, they are commonplace in warehouses and other industrial or commercial workplaces throughout New South Wales.

In certain circumstances, forklifts are also dangerous. Serious or fatal workplace accidents involving or attributed to these vehicles usually happen when the victim:

• Is hit by a forklift because of driver error, working too close to the forklift or inadequate traffic management;
• is hit by a load a forklift was moving because the driver did not use an  attachment when one was needed, or while helping adjust or steady the load;
• is not wearing a seat belt in a tip-over. The forklifts are prone to tipping while operators are turning on uneven or sloping ground.

Common injuries include but are not limited to:

• Superficial and deep bruises;
• broken bones;
• crush injuries involving trauma to skin, bones, underlying tissue and internal organs;
• back and spine injuries;
• head injuries.

Due to the settings in which forklifts are most often used, construction workers and their counterparts working in manufacturing, food, trades, wholesale, transport, mining and agriculture are most likely to be involved in forklift accidents.

What are my options if I was injured by a forklift at work?

If you are an operator or another worker injured in a forklift accident at work, your options for legal recourse and compensation will depend on your specific situation.

Ordinarily, you will be entitled to claim workers compensation benefits and the accident is a motor accident within the meaning of the Motor Accidents Injuries Act which may mean that you can make a third party claim for damages.

You may be able to pursue a civil claim if you can prove that someone’s carelessness contributed to or caused the accident. However, the best way to ascertain this is to consult a qualified lawyer who can thoroughly assess your circumstances and determine whether you have a viable case.

You may also seek compensation if you can prove that your employer’s failure to maintain “suitable conditions” contributed to or caused the forklift accident. This is because all New South Wales employers are legally obligated to:

• make safe work systems available;
• take care of all relevant equipment/machinery and make sure it’s working properly;
• provide a safe working environment;
• ensure that all employees have sufficient training and supervision;
• provide and maintain adequate facilities.

How compensation is awarded

Compensation in forklift accident cases is generally awarded based on several factors. These include but are not limited to the severity of the injury, your age, your overall health, and your occupation.

As in other types of personal injury cases, you may seek compensation for costs incurred due to hospitalisation and other treatment; medical expenses; rehabilitation costs, such as those incurred for physiotherapy and similar treatment; home assistance (if any); loss of past and future income due to the inability to work; and loss of superannuation (if applicable). You may also request compensation for “general damages” such as past and future pain and suffering.

A case in point

In one case, a 65-year-old man injured by a forklift at his Sydney workplace received more than $600,000 in compensation.

The victim reportedly suffered “multiple internal injuries requiring surgery as well as soft tissues to his neck and back” after a co-worker driving a forklift ran into him.

As a result the man had to take a considerable amount of time off work before he could return to light duty. And in spite of his age, he had reportedly intended to keep working  for at least five more years, or as long as he could do so. Unfortunately, however, he never recovered fully enough to do that.

Upon evaluation of the situation, the man’s lawyers determined he was eligible not only to make a Workers’ Compensation claim, but also to pursue a motor vehicle accident claim. This goes to show the importance of getting the proper legal advice from someone qualified to assess your situation as soon as possible. Don’t leave anything to chance. Contact our Sydney Compensation Lawyers for an assessment of your forklift injury case today.

Workplace injuries take a serious toll not only on Australian employers and their employees, but also on the economy. As indicated by statistics gathered by Safe Work Australia, work-related injuries cost the Australian economy approximately $60 billion per year. That’s equivalent to approximately 5% of GDP.

With so much at stake, here’s what you should know about the most common workplace injuries and how to handle them.

The causes of most Australian workplace injuries

Safe Work Australia defines a “serious” workers’ compensation claim as one in which the “compensated injury or disease resulted in one week or more off work”. Preliminary data indicates that Australian workers filed 106,260 such claims in 2016-2017.

Preliminary data for that time also indicates that 40,330 or 38% of the workers who made this type of claim sustained injuries or experienced illness due to “body stressing”. More than 25,000 workers (24% of workers) sustained injuries due to slips, trips or falls; and more than 16,500 workers (16% of workers) got hurt when they were hit by moving objects.

Injuries and illnesses caused by the following accounted for the remaining serious workers’ compensation claims in 2016-17:

• hitting objects with a part of the body;
• mental stress;
• other “mechanisms of incident”, such as biological factors, sound and pressure, roll over, slide or cave-in, and unspecified causes;
• vehicle collisions;
• heat, electricity and other environmental factors;
• chemicals and other substances.

Some common types of workplace injuries

In addition to documenting the causes of most serious workers’ compensation claims in 2016-17, Safe Work Australia tracked the types of injuries the workers sustained. These comprised:

• traumatic joint/ligament and muscle/tendon injury (41%);
• wounds, lacerations, amputations, and internal organ damage (16%);
• musculoskeletal and connective tissue diseases (16%);
• fractures (11%);
• burns (2%);
• intracranial injuries (1%).

That’s a lot of medical jargon so now let’s take a look at what all of this really means.

In layperson’s terms, traumatic injuries involving joints, ligaments, muscles and tendons can also be classified as strains and sprains, depending on their severity. These types of injuries generally occur when poor body mechanics are used during strenuous physical activity, such as lifting and moving heavy objects. However, they can also happen when joints are stressed in slip/trip/fall accidents.

By definition, a wound is generally classified as a bodily injury in which the skin is breached (broken) and “there is usually underlying tissue damage”. Along with these types of injuries, cuts (lacerations) and amputation (the severing of a body part) are usually attributed to workplace accidents involving sharp tools/machinery.

Musculoskeletal disorders may include but are not limited to repetitive strain or repetitive stress injuries, such as carpal tunnel syndrome and tendonitis. When classified as such, they are usually caused by “overexertion or repeating a movement incorrectly for long periods”.

Fractures are simply broken bones. The severity of these types of injuries can vary drastically depending on the mechanism of injury. Workplace accidents that cause fractures include but are not limited to slips, trips and falls.

Next, the medical definition of a burn is “damage to the skin or other body parts caused by extreme heat, flame, contact with heated objects, or chemicals”. Although they account for a very small percentage of serious workplace injuries, the potential for burn injuries shouldn’t be taken lightly.

Although intracranial injuries, or head and brain injuries, also account for a small percentage of serious workplace injuries, they can be among the most devastating. These injuries can happen when workers are hit by moving objects, or when they slip, trip and fall.

What to do about common workplace injuries

If you’ve been hurt at work, it’s important to report the matter to your employer and seek medical attention as soon as possible. It is also important to get the proper advice regarding your rights and options for legal recourse, if any.

Beyond that, there are also certain precautions you can take to reduce the risk of getting injured in the first place. These include but are not limited to:

• using proper body mechanics when participating in strenuous activities, such as lifting heavy loads;
• identifying and removing any tripping hazards;
• quickly identifying and cleaning slippery surfaces, or providing adequate warning;
• wearing proper safety gear;
• getting proper training in the use of heavy/dangerous equipment;
• limiting repetitive activity by varying job tasks whenever possible.

To learn more about common workplace accidents and injuries, and your options if you have been hurt at work, contact our Sydney Compensation Lawyers today.

Workers’ compensation claims can range from minor to extremely serious. The most recent statistics released by SafeWork Australia reveal that for the years 2016 and 2017 there were 106,260 serious Australian worker’s compensation claims. And while the frequency rate of serious claims per million hours worked decreased, the median time lost for a serious workers’ compensation claim increased by 32 per cent. Workers went from missing 4.4 working weeks on average to 5.8.

That amount of time off work isn’t good for the workers, their families, or their livelihoods, but losing part of their workforce is obviously bad for employers, too. To help alleviate some of the difficulties surrounding the claims process, the New South Wales Government decided to make changes that would streamline the options for workers when their claims are unsuccessful and, hopefully, make the entire dispute resolution process faster and more understandable.

Changes to dispute resolution for Workers’ Compensation

In October of 2018, the New South Wales Government announced changes to how workers’ compensation disputes will be decided. Those changes begin to take effect from early 2019. The goal of this shift was to improve the existing system by enhancing support services, streamlining the claims process, and eliminating duplication. Working together, these changes will hopefully improve the overall claims process experienced by injured workers in New South Wales.

Why change the system?

As the old saying goes: “If it ain’t broke, don’t fix it.” So what was broken about the old system? For one thing, claimants were found to have low levels of satisfaction with the existing claims system. Some of the issues that caused this dissatisfaction included: confusion about the claims process; lack of support; and the fact that the claimants had to fight against better prepared, better equipped insurance companies.

When workers wanted to file a claim, they were forced to reach out to several different organisations for opinions on whether or not they were even eligible to fight a decision. With a system so clearly biased against them, it’s no wonder that physically and psychologically injured workers were so dissatisfied.

Major changes

With sustainability in mind, the more ‘user-friendly’ system has made the following changes:

• Workers will no longer be forced to go through multiple agencies to file a claim. The State Regulatory Authority (SIRA) and the Workers Independent Review Office (WIRO) will no longer undertake dispute resolution following internal review by an insurer. This will now be the responsibility of the Workers Compensation Commission, greatly simplifying the process.
• SIRA will now field all employer and other system participants’ inquiries and complaints.
• WIRO will now handle the complaints of injured workers that are not resolved in the first instance by their insurer.
• The calculation process for pre-injury earnings has been simplified, which will increase the transparency of the claims process and streamline claims processing.
• There will no longer be mandatory internal insurer review to determine work capacity.

These changes were decided after an extensive review that involved in-depth consultation with industry stakeholders, injured employees, and representatives from various organizations (SIRA, WIRO, and the WCC). The recommendations of the Legislative Council Standing Committee on Law and Justice were also considered when developing the reform.

A workers’ compensation claim can be extremely disruptive in the lives of many, especially if the initial claim is unsuccessful. Hopefully, these new changes to dispute resolution will help get injured employees the help they need more efficiently and with less bias toward the insuring entities. If you or a loved one have any questions regarding workers’ compensation, steps to take after a failed claim, or any other legal concern, please contact our Sydney Compensation Lawyers as soon as possible.

Construction workers experience some of the most dangerous conditions of any workplace. In the course of their day-to-day jobs, they handle heavy machinery, hazardous chemicals, extreme heights, and are exposed to the elements. Unsurprisingly, along with emergency services, these conditions make construction sites some of the most dangerous workplaces in Australia. According to Safe Work Australia, in 2017 the construction industry saw 33 on-the-job fatalities, with 21 reported in 2018 at the time of the report, making the construction industry the third-most dangerous industry in which to work.

Common construction hazards

Due to the highly demanding nature of construction jobs, there are a number of common causes for both injury and fatality:

• Chemicals: Construction sites often make use of hazardous chemicals which can cause chemical burns or poisoning with immediate contact, as well as long term respiratory illnesses.
• Noise: Construction sites use loud machinery and equipment such as power tools, jackhammers, bulldozers and more. Long term exposure to these noisy machines can result in headaches, ringing in the ears and even hearing loss, often called ‘industrial deafness’.
• Exposure to the elements: Most construction work takes place outside while exposed to sun, wind and inclement weather. Sun exposure can cause sunburn, skin cancer, dehydration and heatstroke, particularly in certain areas of the country. Windburn can also damage skin, and inclement weather such as rain or high winds can lead to unfavorable working conditions and contribute to other mistakes and malfunctions.
• Vehicle accidents: Construction work requires the use of heavy driving equipment including big trucks, earth-moving cranes and excavators which can cause a great deal of damage if involved in an accident, malfunction, or are mishandled. Additionally, when construction workers are on the road, they run the risk that drivers are not exercising the necessary level of caution and can hit them causing injury or death.
• Moving or falling objects: Heavy lifting, either manually or with machinery, is a standard activity in construction work. Unfortunately, even a small miscalculation can result in death and injury with an object falling from overhead.
• Slip & falls: As with any workspace, slip and falls are inevitable. However, with loose tools, debris and slick materials, construction sites are particularly rife with risk.
• Height work: Many construction jobs deal with erecting buildings. This means working on ladders, scaffolds, or barely constructed upper floors. Falling from one of these areas will often result in extreme injury or death.
• Electrocution: Working with exposed wires, faulty cords, or downed powerlines can result in a powerful electric shock.
• Machinery: In addition to the larger equipment mentioned above, smaller tools such as power saws, drills, nail guns and electric sanders also pose a significant threat to safety as improper use or malfunction can cause cuts, punctures, bruises, lacerations and amputations.

Workers’ compensation for construction injuries

If a construction injury was caused by another person’s negligence, carelessness or a machinery malfunction, the injured party may be able to claim under a workers’ compensation scheme. All employers are required by law to provide their workers with: safe work systems, properly maintained machinery and equipment, safely maintained work environment, adequate facilities, adequate training, sufficient supervision and thorough instruction.

If your injury is the result of negligence by your employer to provide any of the proceeding work conditions, you may be able to file a claim and receive personal injury compensation. Luckily, this can cover injuries that affect you in the short term or in the long term, including late-onset injuries (cancer, illness, whiplash, etc.) and aggravations of pre-existing conditions (ligament tears, knee, back and hip injuries).

Claims against other contractors

Construction sites usually have many companies working with or around you. If a construction injury was caused by the negligence etc. of or more of these businesses, that is, a person who is not your employer, then you might also be able to file a claim against them.

What you may be able to claim

General damages: These damages cover the pain and suffering that you experience due to your injury. If your quality of life is permanently reduced, you may also be compensated in relation to that.

Medical costs, including hospital and rehabilitation: After an injury, you will be required to undergo diagnosis and treatment. Depending upon your injury, you may also need to receive rehabilitation service or home care, surgery, hospitalisation, or the use of special equipment such as braces or a wheelchair.

Loss of present and future income: While you are out of work to take care of your injury, you will not be receiving your usual wage. You may be able to recover lost wages, both in the present and in the future depending upon the circumstances and the severity of your injury.

Like most areas of law, workers’ compensation involves serious time restrictions. These are made all the more serious by the potentially devastating long-term health effects that can go hand-in-hand with such a claim. The most pressing questions you will likely have are: “How much is this going to cost and where am I going to get the money to pay for it?!” When you have suffered an injury, the last thing on your mind will be meeting deadlines but unfortunately, in order to get the compensation that you are owed, paying close attention to time limits is a must.

When Can I Make a Workers’ Compensation Claim?

Four conditions must be met in order for an injured party to file a workers’ compensation claim. First, and most obvious, the worker must be an employee. Second, the employee in question must have suffered an injury or medical condition that a medical practitioner has diagnosed. The injury or medical condition must have been sustained in the course of employment and where the employment itself substantially caused the injury or condition. Finally, the employee has suffered or is suffering an economic loss due to the injury.

Notifying the Appropriate Parties

When the injury occurs, the injured employee needs to notify their employer of the incident and resulting injury or condition. The employer must be notified, in writing, of the injured worker’s name and address, what the injury is and how it occurred, and the date that the injury occurred.

Time Limits

In general, all workers’ compensation claims must be made within six months of the date that the injury occurred. However, this limit can be extended for up to three years if certain circumstances are met.

Exceptions

In circumstances where reasonable cause can be shown, the time limit can be extended from six months to three years. Reasonable cause may be shown in cases where there is an absence from the state, there has been a mistake, or in cases where the employee discovers their injury after the fact. In the event the injury or condition is not known until much later (for instance, whiplash, cancer, vision, or hearing problems), the time limit for filing a claim starts not at the time of the injury but at the time that the employee becomes aware of the injury and what caused it.

What Might Cause Someone to Miss the Deadline?

Aside from the obvious answers of mistake, confusion, or simple forgetfulness (all of which can be remedied by the involvement of a professionally trained workers’ compensation attorney) there are a few other reasons the claim might be made late.

Belief that the Injury Will Heal

As mentioned before, some injuries may take time to manifest in serious symptoms. Sometimes, what seems like a minor injury ends up having more serious consequences. In these scenarios, an injured employee might try and wait to see if the injury or condition goes away on its own. However, this can not only prevent them from recovering the appropriate amount of compensation, but might cause the injury to get worse in the meantime.

Fear of Retribution

Another reason that an injured employee might wait to report (or not report at all) is fear that they will experience discrimination from their employer. It’s a competitive world and no one wants to be seen as ‘troublesome’. However, there are laws in place to protect employees from being dismissed or punished for filing a workers’ compensation claim.qq

To meet important deadlines with any workers’ compensation claim, it is vital to act as soon as possible and get in touch with an experienced workers’ compensation lawyer who can help you stay on track with your claim.

Established in 2012, WIRO – the Workers Compensation Independent Review Office – is an independent statutory office. But what function does it serve and how can it help you?

In short, WIRO is meant to help resolve disputes between employees and insurers in workers’ compensation matters. If and when a claim is denied or an employer needs assistance navigating the world of workers’ compensation premiums, WIRO may be able to provide assistance. The distinctive thing about WIRO is that they attempt to resolve these issues for free while avoiding litigation and an adversarial process.

WIRO are contactable on 13 94 76.

Workers’ Compensation in Australia

From 2012-2013, SafeWork Australia reports that 117,815 serious compensation claims were made by workers throughout the state. Due to the physically demanding and dangerous nature of their jobs, it is unsurprising that the most common types of workers’ compensation claims were made by labourers, machinery operators and drivers. Back injuries are extremely prevalent and because they tend to have slow-to-appear symptoms, they often result in long lasting and expensive consequences. Other commonly claimed injuries include hearing loss, vision loss, shoulder injuries, and psychological injuries. All of these are claims that WIRO can help with.

How WIRO Can Benefit the Employee

Workers’ compensation exists to aid and protect workers who are injured in the course of their employment. A complicated insurance process means that many injured workers can become overwhelmed or frustrated by the often complicated claims process. Even more so when something ‘goes wrong’. What if the insurer decides you’re able to go back to work before you’re ready, or rejects your claim? In addition to the confusing nature of workers’ compensation, you would then be forced to try and fight against your insurer, potentially while dealing with the effects of a serious injury.

This is where WIRO can step in and help. WIRO focuses on dealing with the insurer in a number of ways. When a claim is denied, payments are delayed, medical treatment is debated, liability is refused, claim determination is overdue, or payments are reduced, WIRO may intervene.

How WIRO Can Benefit the Employer

While employers are often the first place injured employees go to for guidance, they are also faced with an abundance of challenges when coordinating with insurers to handle liability issues. Not only are they torn between protecting their employees and defending their business from liability, but they have the obligation of dealing with insurance companies. Again, WIRO may be able to help. By referring to WIRO, employers faced with workers’ compensation issues can receive aid with:

• management of claims and handling;
• calculating compensation premiums;
• determining compensation premiums;
• liability concerns (including claim acceptance or denial);
• any action taken (or NOT taken) by the specific insurer.

WIRO’s Complaints Handling Process

First, WIRO requires you to seek a review of any compensation issues with your insurer before coming to them for aid. Once all other avenues of relief have been exhausted, then WIRO can step in an offer assistance. WIRO focuses on the use of Alternative Dispute Resolution techniques first and foremost and will only resort to a more formal and in-depth investigation if all other attempts at resolution have failed.

If WIRO cannot obtain a resolution to your problem, then WIRO may refer you to a WIRO approved lawyer for assistance. We here at BPC Lawyers are able to assist you in such an eventuality.

Most Australians know that they can file a workers compensation claim if they get hurt on the job. But did you know that may not be your only option? You may also be able to make a claim through your superannuation account. This is because superannuation programmes generally offer various types of insurance coverage. This article provides a basic overview to familiarise you with this issue.

In general, insurance provided through your superannuation will provide coverage for any illness or accident resulting in an injury that prevents you from working.  However, one of the most fundamental and crucial issues to understand in this context is that there may be different rules associated with the insurance provided through different superannuation programmes.

Some funds will only offer insurance to active members – those who are making contributions – while others will continue to provide cover once you’ve stopped contributing.  In some cases you won’t be eligible for the coverage unless you ‘opt-in’. If your superannuation fund offers ‘default cover’ for its members, however, you will automatically qualify for the coverage. Many policies also allow you to make a claim even if you are no longer working and are not currently insured – but only if you were covered at the time you were hurt.

Another important point to bear in mind is that just because you have coverage, it doesn’t mean your claim will be successful. It is not unheard of for a fund to deny a claim without a valid reason, and so it is essential that you consult an experienced lawyer prior to pursuing this option.

The Types of Claims Available

A lawyer who is well versed in this area can do a comprehensive review of your situation and discuss what you must do in order to prove total and permanent disability (TPD).  A TPD claim is one in which you must demonstrate that you can no longer do the type of work you were doing when you were hurt, or any type of work for which you are qualified based on your education, training or experience.

The reason this is so critical is that TDP, or ‘disability cover’, is the type of insurance coverage most often offered as ‘default cover’ by superannuation funds. Furthermore, successful TPD claims typically result in single (lump sum) payments rather than payments made over time. How much you will get depends on several factors including the extent of your injury and your policy terms.

Depending on your unique circumstances and the provisions in your superannuation insurance policy, you may also be able to make claims for temporary disability or income insurance.  If you make a successful claim for the former, you’ll most likely get monthly payments until you can resume working. A successful income insurance claim usually results in compensation for up to 80 percent of your average income, with payments being made for a maximum of two years. You should also be aware that you can usually make these types of claims through your superannuation fund even if you’re already receiving reimbursement through workers compensation, and that you can make your superannuation insurance and workers compensation claims simultaneously.

More Than One Super Fund?

Another question that often arises in this context is what you should do if you have more than one superannuation account. If you follow conventional wisdom, you may be tempted to combine all of your accounts so you don’t have to pay any fees or premiums on any funds not in active use. That can be detrimental for insurance purposes, however, because different superannuation insurance programmes have different rules. If you combine all of your accounts without getting the proper advice, you may end up with insurance that doesn’t meet your needs.

In summary, if you have a superannuation account, you also have options if you are hurt at work. In addition to pursuing a claim through workers compensation, you may also be able to make a claim through the insurance associated with your super fund. Because different insurance plans offered through superannuation funds have different rules, you may have to opt-in to ensure that you have cover. In most cases, you will probably have ‘default cover’ as an active participant in a super fund but in order to make a successful claim with this type of insurance, you must usually prove that you have TPD. Finally, you should always consult a qualified professional about the insurance ramifications before you consolidate multiple superannuation accounts.

If you have been hurt at work and you want to know more about your options for seeking compensation through your super fund, it is important to get proper legal advice as soon as possible. Contact our Compensation Lawyers Sydney for a free case evaluation now.

In this podcast, personal injury lawyer, Tim Driscoll discusses the possibility of making a worker’s compensation claim even years after the accident had happened.

Podcast: Play in new window | Download

In recent years, changes to relevant New South Wales laws made it difficult – if not impossible – for people whose work-related injuries worsened over time to seek compensation for necessary treatment, including surgery. But this could soon change, thanks to a recent NSW Workers Compensation Commission ruling in the case of a retired railway worker.

The worker, Sam Baldacchino, hurt his knee on the job while working for Pacific National (then Freight Corp) back in 1999. The injury worsened over the years, causing the joint to deteriorate so much that doctors recently advised him to have it replaced.

By 2016, there was ample evidence that:

1. The joint deterioration that occurred over time was related to a work-related injury sustained in 1999;
2. He needed the knee replacement because of the initial injury; and
3. The surgery meets the legal criteria for an ‘artificial aid’ under relevant laws.

Even so, the case went to arbitration, where the insurer made several arguments. After the Arbitrator found its first contention lacked merit – namely that the surgery was unrelated to the initial injury sustained on the job – the insurer raised two additional contentions about Mr Baldacchino’s right to “claim surgery.”

First, the insurer pointed out that he was no longer eligible for additional weekly benefits, and it had been more than five years since his receipt of such payments ended.  This is an important distinction because of two new provisions in section 59A of the Workers Compensation Act 1987.

Subsection 59A (1) specifically states: “Compensation is not payable to an injured worker under this Division in respect of any treatment, service or assistance given or provided after the expiry of the compensation period in respect of the injured worker.”

Furthermore, subsection 59A(2)(b)(ii) defines a five-year compensation period as one applied to a work-related injury resulting in a legally acceptable degree of permanent impairment that begins on “the day on which weekly payments of compensation cease to be payable to the worker (if weekly payments of compensation are or have been paid or payable to the worker).”

Based on these provisions, the insurer argued, Mr Baldacchino had no right to any compensation for his knee replacement surgery.

However, another new stipulation in section 59A of the Workers Compensation Act 1987, lists the exceptions to this rule. As per subsection 59A(6)(a), the time limits do not apply to “the provision of crutches, artificial members, eyes or teeth and other artificial aids or spectacles (including hearing aids and hearing aid batteries).”

In this case, the insurer argued that the term “artificial aids” did not apply to knee replacement. In its opinion, the term only applies to “external” devices. However, the Arbitrator disagreed based on legal precedent, and his decision was upheld appeal.

Time will tell what happens next. Of course, the insurer could still take its arguments to the New South Wales Court of Appeal and even the High Court of Australia but even if it does, there is no guarantee it will prevail.

In any case, if the decision remains unchallenged, or if it is challenged and stands, it will undoubtedly make life easier for those who need knee replacements due to work-related injuries that have resulted in catastrophic joint damage over time.

Legal experts are also hopeful that other joint replacements will also be legally classified as “artificial aids” in this context, and there is some speculation that similar surgical intervention to treat worsening work-related injuries may also be included.

But what if you are currently suffering from the long-term effects of a work-related injury that doesn’t require joint replacement? Or what if you are suffering from the long-term effects of an injury that happened at work but wasn’t immediately evident?

In such cases, your chances of receiving compensation will probably depend on several factors. These include but are not limited to the nature of your injury, the extent of prior compensation, if any, and the nature of your claim for reimbursement.

Clearly, this is a complicated legal issue. And although there have been positive developments on this front, there is no guarantee that the Commission’s decision will stand. Furthermore, every case is different, and the outcome generally depends on the unique circumstances of each case.

If you were injured at work and the injury wasn’t immediately apparent, or it has gotten worse over time, it is important to seek advice from a qualified lawyer about any compensation to which you may be entitled. Because your physical, emotional and financial wellbeing are at stake, you should also seek advice from an experienced lawyer about your options if your claim has been denied. Don’t suffer in silence. Contact our Compensation Lawyers Sydney today.

If you were hurt at work or you have been diagnosed with a work-related illness in New South Wales, you probably feel as if you’ve been put through the proverbial wringer.  In addition to the pain and suffering you’ve experienced, you’ve had to deal with the emotional and financial stress stemming from mounting medical expenses and lost income due to your inability to work.  To make matters worse, you’ve just learned that WorkCover have rejected your claim. The good news is there is something you can do.

In order to dispute WorkCover’s determination, it is important to understand why your claim was rejected. Of course, the reason will depend on the specific circumstances of your case.  Whatever their reason, they must provide you with their decision in writing.

In general, WorkCover routinely denies claims because:

• The person making the claim does not meet the legal definition for a ‘worker’;
• The illness or injury wasn’t entirely work-related, or
• The compensation sought is excessive given the nature and extent of the illness or injury.

WorkCover may also reject your claim if no one saw what happened; if there are any inconsistencies between your account of what happened (on the initial accident report) and evidence (including medical records); if there is reason to believe you were under the influence of drugs or alcohol at the time of the accident; or if there is reason to believe you have a pre-existing condition that caused or contributed to your illness or injury.  By far, the most common reason for denial, however, is the failure to report the accident to a supervisor immediately.

With all of that being stated, there are a couple of things to keep in mind.  First of all, your legal classification as something other than a regular, full-time employee does not preclude you from seeking worker’s compensation.  Secondly, lack of witnesses is not automatic grounds for denial of the claim if you sustained a serious or catastrophic injury and there is no doubt as to how it happened.

It is also important to note that the way in which you can dispute WorkCover’s initial determination depends on where you work, because there are different rules for doing so in each state. In New South Wales, you can begin by asking the insurance provider for a review. You can do this by stating your reasons for the request on the application form supplied by the insurance provider.  You should also provide additional evidence or information to support your case along with this form. You should get an answer within 14 days.

In a best-case scenario, WorkCover will reverse its previous decision and accept your claim.   If it doesn’t, you still have options.

If the insurance provider stands by its initial decision upon review, your next step is to seek assistance from the Workers Compensation Committee (WCC).  Operated by the Government, the WCC addresses disagreements between worker’s compensation claimants and employers or insurance providers.  Depending on the circumstances of your case, WCC may assign someone who is well versed in worker’s compensation law, called an arbitrator, to help resolve the matter.

Bear in mind, however, that the WCC will not accept any new evidence at this time. Instead, it will only consider the merits of material you initially provided on the accident report and request for review.

You should also be aware that you don’t need to do all of this yourself.  At a time when you and your loved ones are likely feeling intimidated and overwhelmed by everything you’ve gone through, it is important to retain a skilled and knowledgeable worker’s compensation lawyer who can thoroughly assess your case and fight for your rights. To learn more about how we can help if WorkCover rejected your claim in New South Wales, contact our Sydney Compensation Lawyers today.

For many Australian workers, dealing with a stressful workplace is par for the course. Tension with co-workers or supervisors, deadlines, difficult clients or customers and constant doubts about job security can all make for a challenging environment. Sadly, many Australians have also experienced workplace bullying or harassment and now suffer from depression and anxiety. If you’re dealing with any type of psychological trauma sustained at work, you may be able to apply for workers’ compensation in New South Wales.

To make a successful claim on these grounds, you must prove that you meet certain standards. Specifically, you must provide adequate medical verification that you suffer from a permanent psychological injury or similar condition caused by your job that interferes with your ability to function normally.

In and of itself, a prescription issued by your own doctor for time off to recover from work-related stress is not sufficient proof. Instead, you must see an authorised specialist trained to assess your condition. At your appointment, he or she will do tests to determine the extent of the emotional and/or psychological trauma you sustained. The specialist may also consider:

• Medical reports;
• Test results;
• Statements from relatives, co-workers and friends, and
• Your own statement (s).

If the specialist finds it is no less than a ’15 percent impairment of your whole person,’ you should be able to make a worker’s compensation claim for a chronic ongoing condition.

Nationally, more than 7,000 Australians receive compensation for work-related mental heath conditions each year, accounting for roughly 6 percent of total workers’ compensation claims. However, the total workers’ compensation payments made for these claims is more than $540 million.  A closer look at government data for FY 2010-11 through FY2014-15 also reveals that the typical reparations made for this type of claim totaled $24,500 in comparison to $9,000 for all other claims.

Successful claims generally provide reparation for lost wages stemming from your inability to work, medical expenses, and ancillary costs. However, the amount you will receive depends on the specific circumstances of your case.

Before you make a claim, you should be aware that it is s unlikely you will prevail if your condition stemmed from any action that can be legally classified as ‘reasonable management action.’ This includes a job transfer, demotion, dismissal or reassignment, as long as your employer can prove it was ‘reasonable.’ Under this definition, for example, mandated participation in a job assessment may also qualify as reasonable action.

Even if you aren’t eligible to make a worker’s compensation claim, you may be able to pursue other legal recourse if you suffer from psychological trauma resulting from workplace bullying. This is because the Fair Work Act includes anti-bullying provisions allowing the Fair Work Commission to make orders to stop the behaviour from continuing. However, be aware that settling a claim in the Fair Work Commission may mean that you cannot make a claim for workers’ compensation.

By far, the worst thing you can do if you have experienced emotional distress or are experiencing significant psychological trauma stemming from work, is to remain silent. After you’ve seen a qualified mental health professional, it is important to get the proper legal advice. To learn more about how we can help you make a worker’s compensation claim or pursue other legal remedies, contact our Compensation Lawyers Sydney today.

A worker who is injured at work is entitled to compensation benefits including (subject to restrictions) payment of medical expenses, compensation for wage loss and compensation for permanent impairment suffered.

Injuries suffered in the course of employment can often need little by way of time off work or treatment. However, even the most innocuous incident can lead to considerable financial and medically disastrous results. They can, at first, seem not to have caused much by way of damage. However, it can take considerable time for symptoms to materialise or an employee may fear for their job if they make a claim.

When?

It’s imperative that workers lodge incident reports and workers compensation claim forms for all incidents to which they have suffered injury. These forms are available from your employer and must be provided upon request. It is also advisable to seek medical attention by your local medical physician so that your medical condition is documented and you obtain an opinion as to the severity of your condition. This claim form must be as comprehensive in detail as possible, including all injuries suffered, even when the symptoms seem mild at the time.

Why?

The Workers Compensation legislation sets time limits for the lodgement of claims. Any delay could mean that you lose the right to compensation. You must inform your employer that you have suffered an injury as soon as possible: Section 254 Workplace Injury Management and Workers Compensation Act 1998 (NSW).

If you did not inform your employer and wish to make a claim, you must show special circumstances, including:

• That the employer hasn’t been placed into a position of disadvantage in responding to or dealing with your claim,
• You did not tell your employer due to your “ignorance, mistake, absence from the State or other reasonable cause”,
• Your employer knew about your injury anyway, or
• Your employer reported the circumstances to the nominal insurer.

You must also then lodge your claim for compensation within 6 months of the injury: Section 261 Workplace Injury Management and Workers Compensation Act 1998 (NSW).

If you lodge a claim after the six month period, you must show special circumstances, including:

• You didn’t lodge you claim in time due to some ignorance, mistake, absence from the State or other reasonable cause AND you made the claim within 3 years of your injury;
• You didn’t lodge a claim in time due to some ignorance, mistake, absence from the State or other reasonable cause AND your work incident has caused serious and permanent disablement;
• The insurer accepts your claim and fails to mention this issue, or
• Your injury was only realised after the incident and you have complied with one of the conditions listed above.

Conclusion

We strongly advise you to immediately lodge a claim for workers compensation and notify your employer of any injury. This will ensure your rights to compensation aren’t taken away from you, especially if there is a delayed or late onset of a serious condition. Indeed, I have come across many situations where employers have attempted to convince workers not to make workers compensation claims, instead agreeing to meet their time off work and treatment expenses themselves. Whilst workers may wish to keep their employer happy for reasons of job security, it must always be borne in mind that such agreements with your employer are far from secured long term. Given the protection from termination for 6 months from your claim (Section 248 Workers Compensation Act 1987) and the common uncertainty as to how long your condition may take to recover, the prudent course must be to lodge a claim for workers compensation. Should your condition require surgery, or seems to be causing you serious and permanent financial and medical hardship, you should contact our office in order to seek advice as to what other rights you might have to compensation.

Timothy Driscoll LLM (Sydney) Associate of BPC 4 October 2017

Apart from the payment of workers compensation, an employer has an obligation to rehabilitate the injured worker, including, where able, to facilitate the worker into another position; whether that be within or out of the organisation.

However, as is becoming more apparent, employers are finding it easier to simply get workers off their books than having to deal with their rigorous obligations for the payment of compensation, rehabilitation and redeployment of workers.

So if you’re a worker who has suffered an injury at work and your employment has been terminated, what can you do? What rights are you afforded? 

An injured worker is afforded some protection from termination under Part 8 of the Workers Compensation Act 1987 (NSW). 

The extent of protection will however depend upon: 

1. Whether you’re fit to perform your pre-injury job, and/or
2. The reasons for why your employer terminated your employment.

Unfit to work in pre-injury employment

If you cannot do the inherent requirements of your job, your employer can terminate you.

However, it is a criminal offence for your employer to terminate your employment because you’re unable to perform such requirements because of a work injury IF they terminate you within 6 months from when you first become unfit for your pre-injury job.

Whilst this prohibition is a criminal provision, the conduct of your employer in terminating you because you make a claim for workers compensation will create a civil liability upon your employer, to which you can sue for modest compensation under the protections found in the Fair Work Act (Cwth).

This protection is only available to you if you comply with any reasonable request the employer makes to send you for a medical examination on the matter.

Fit to work in pre-injury employment

If an employer terminates your employment because you’re unfit for work (so they allege) due to a work injury which you’re fit to perform, then another remedy might be available to you.

If, after termination, you send your employer a medical certificate certifying you’re able to do you pre-injury job or another job up to the same vantage point as your old job, then the employer must reinstate you into that position which you have capacity.

Interestingly, if your employer wishes to allege that you’re not entitled to reinstatement as your injury is not work related, then they must overcome a presumption that says otherwise. That is, it is up to them to rebut a presumption that your termination was because of some non-work related condition.

Conclusion

The general rule has always been that an employer can terminate your employment for any reason at any time.

That still remains the general proposition at law.

But depending on the reasons or reasonableness for their decision might determine if and to what extent you can seek a Court or Tribunal to correct the effect of this decision.

For workers injured in the course of their employment, the Workers Compensation Legislation works (or at least is designed to work) hand in hand with the Fair Work Act 2009 (Cwth) to provide assistance above that of the ordinary worker who has had their employment terminated. However, as is seen in this article, the Court/Tribunals can have great difficulty in providing a fruitful remedy to an employer’s termination notice.

The question is what avenue best achieves the best outcome for the worker?

This is a question of fact and degree of the particular case, to which will need assessment by a competent legal advisor within the area.

If you have been seriously injured at work and are worried about the future in the workforce, then you should contact our office right away and speak to one of our accredited specialists.

Timothy Driscoll

Associate

14 August 2017

Workplace incident at Barangaroo – Nervous Shock Claim

Lawyers have represented vast numbers of plaintiffs in successful nervous shock claims pursuant to the NSW Civil Liability Act 2002 since its inception.

Nervous shock claims can be brought by persons who have witnessed, at the scene, a victim being killed, injured or put in peril if it is accepted by the Court that they have genuine psychiatric illness arising from a circumstance that the defendant ought to have foreseen to be capable of causing a person of normal fortitude to suffer a recognisable psychiatric illness if reasonable care were not taken.

If a genuine psychiatric injury is suffered by a close member of the family of the victim who was killed, injured or put in peril, they need not have witnessed, at the scene, the relevant event.

The Civil Liability Act defines a “close member of the family” of a victim to include a parent of the victim or other persons with parental responsibility for the victim, or the spousal partner of the victim, or a child or step-child of the victim or any other person for whom the victim who has parental responsibility. The definition extends to siblings, half-brothers or half-sisters, step-brothers and step-sisters.

A “spouse or partner” is defined as a husband or wife or a defacto partner.

The Diagnostic Statistic of Psychiatric Injuries is used by qualified psychiatrists to report to the Courts on behalf of parties to litigation in relation to the effect that a particular event has had upon any witness to an event causing psychiatric injury.

Strict time limits apply in relation to bringing a claim for damages for personal injury, including psychiatric injury, pursuant to the Civil Liability Act. A three year limitation period is imposed in relation to commencement of court proceedings, which runs from the date of the relevant event.

It is expected that in relation to the unfortunate death of an innocent worker at Barangaroo in March 2017, there will be a coronial inquest that will shed light upon the circumstances that led to the death.

The findings of a coroner should not be pre-empted.

Any persons who have witnessed, and been psychologically affected by the unfortunate incident at Barangaroo are advised to consult medical practitioners for appropriate treatment.

Claims for damages for pure mental harm or nervous shock should only be brought by individuals who have suffered very significant psychological injury as a result of a particular event. The court process usually endures for beyond 18 months if matters are incapable of settlement.

The Civil Liability Act is designed to provide appropriate compensation to persons with significant injuries that negatively impact upon their ability to earn an income and which give rise to significant medical expenses.

The Courts, quite rightly, do not readily entertain cases that do not involve genuine psychiatric injury, as was intended by the legislators when the Civil Liability Act NSW 2002 was enacted.

BPC Lawyers have acted for injured plaintiffs for in excess of 35 years.

If you or one of your loved ones is affected by psychiatric injury which remains unresolved despite medical treatment, please contact one of our accredited specialists in personal injury law in NSW for a free initial consultation.

BPC  Lawyers act in nervous shock claims on a “no win/no fee” basis.

In cases involving serious injury or death, there will usually be a coronial inquest following police investigations and WorkCover/WorkSafe investigations.

BPC Lawyers have assisted family members to protect their compensation rights by appearing in numerous coronial inquests, including those involving construction site accidents and deaths.

Compensation Lawyers Sydney at BPC Lawyers take very seriously their duty to only bring cases on behalf of persons in circumstances where there is at the very least, a reasonable prospect of success, which is consistent with our obligations pursuant to the Legal Profession Uniform Law.