Sydney Workers Compensation Claims

Suffered an injury at work? We Can Help! Free Consultation & No Win-No Fee

After my accident the claims process was overwhelming.
The insurer was difficult to deal with and I didn’t know who to trust.
They offered me peanuts for my claim. I was lucky to find you.
Thank you for all the help, you were honest and upfront from the start
and the result was superb.
All the very best to you and your staff. Marni, Narellan Vale

FREE CONSULTATION

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.

If you would like more information, contact BPC Lawyers for a Free, No Obligation Consultation

What is WIRO?

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.

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 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.

Can I Sue My Employer?

Ordinarily, the law requires you to bring this kind of cause of action within 3 years of its occurrence.

However, when suing your employer, the Court is given the power to extend this time. Traditionally it would grant such an extension provided that it was satisfied a fair trial would be conducted; that is, that the Defendant was not materially prejudice by the delay in bringing the action out of time.

READ MORE

How To Make A WorkCover Compensation Claim

The definition of a worker includes:

Those that work for an employer as an employee under a written or oral contract of service;
A “deemed” worker, that is contractors who should be treated as employees.
If you fall in to one of the above categories and have sustained an injury either in the course of your employment or either travelling to or from work then you are entitled to make a claim for compensation. Mostly it does not matter whose fault it was that caused the injury.

READ MORE

Workers’ Injury Management Guide.

If a worker is injured an employer must:

Attend to the injured worker as soon as possible;
Notify the insurance company within 48 hours;
Co-operate and participate with the insurance company to develop an injury management plan;
Implement and monitor a return to work plan for the injured worker.

READ MORE

An Expert Workplace Injury lawyer Will Help Advise You On.

  • Gathering medical records and relevant evidence
  • Refuting the claims of any independent doctors from WorkCover
  • Whether you have the right to seek additional medical opinions to help support your claim
  • Who is liable to pay for the medical reports and bills; including any union assistance

If you have suffered a work-related accident, don’t be afraid you will be fired. It is actually within your employer’s best interests to keep you employed and to comply with the accident compensation claim. So speak to an expert workers compensation lawyer at Beilby Poulden Costello early, to help clarify your rights and your employer’s legal obligations to compensate your injury.

If your accident occurs due to the fault of your employer or some third party you may have a right to bring a common law claim for damages. This type of claim may be far more substantial than your WorkCover claim. Our experienced team of personal injury lawyers can advise you of your rights and entitlements and ensure you get the compensation you deserve.

Are You Covered and What Are You Entitled To

In New South Wales the Workers Compensation Act provides financial protection to all workers in the event that they are injured or killed at work or suffer a work related disease.

The act states that a worker, who has received an injury at work, shall receive compensation from the worker’s employer. In the event that the injury results in the death of a worker, then the worker’s dependents shall be entitled to receive this compensation.

If you are injured at work you will be entitled to receive workers compensation which includes:

  • The payment of weekly compensation benefits until you are able to return to work.
  • The payment of your reasonable and necessary medical bills for treatment you require as a consequence of your work place injury including physiotherapy.
  • The payment of any costs associated with your rehabilitation to enable you to return to work including retraining if you are no longer able to continue doing the same work as a result of your work place injury.
  • Lump sum payments of compensation if you have suffered a permanent impairment of a certain level.
  • Lump sum payments of compensation for pain and suffering if your work place injuries are assessed at a certain level.
  • Payment of your legal expenses incurred in making a claim for compensation.

Workcover Insurance

The Workers Compensation Act makes it compulsory for employers to have a workers compensation policy if they pay more than $7500 in wages per annum, employ an apprentice or trainee, or are part of a group for premium purposes.

These policies of insurance are called “WorkCover Insurance”.

WorkCover NSW is part of the Compensation Authorities Staff Division. The Division was formed as an administer for work health and safety, injury management, return to work and workers compensation laws and manage the workers compensation system.

The aim of WorkCover Insurance is to ensure that all workers will receive their statutory entitlements to workers compensation if they suffer a workplace injury, regardless of the financial status of their employer. Employers pay a premium each year for their WorkCover insurance depending on the number of employees they employ and various other factors.

If you are injured at work you will be entitled to receive workers compensation which includes:

  • The payment of weekly compensation benefits until you are able to return to work.
  • The payment of your reasonable and necessary medical bills for treatment you require as a consequence of your work place injury including physiotherapy.
  • The payment of any costs associated with your rehabilitation to enable you to return to work including retraining if you are no longer able to continue doing the same work as a result of your work place injury.
  • Lump sum payments of compensation if you have suffered a permanent impairment of a certain level.
  • Lump sum payments of compensation for pain and suffering if your work place injuries are assessed at a certain level.
  • Payment of your legal expenses incurred in making a claim for compensation.

Workers Compensation Changes in NSW

The NSW Workers Compensation scheme has recently undergone some radical changes.

These changes have/will apply to ALL workers regardless of when their injury occurred UNLESS

  • You were injured whilst and as result of employment with NSW Ambulance employee
  • You were injured whilst and as result of employment with NSW Police
  • You were injured whilst and as result of employment with NSW Fire Brigade
  • Your claim is covered by a ComCare System or another state scheme.

The Old System
Generally, the old System provided all workers the following ongoing rights:

  • Payment for all medical expenses properly incurred because of a work related injury
  • Payments (capped) for time off work due to work related injury, and
  • Payment for permanent impairment suffered because of a work related injury including a sum for pain and suffering between $0.00 and $50,000.

New Restrictions
For most workers, the new system provides for many restrictions which must be considered.

Medical Expenses
Payment of medical expenses is limited in two very limited respects.

Firstly, pre-approval is required from the insurer before they are liable for the medical expense

Secondly, you can only recover medical expenses up to 12 months from your last receipt of weekly wage compensation benefits.

Hearing Loss Claims
As most workers who are suffering a hearing loss don’t have much time off due to their injury, coverage for medical expenses only lasts for 12 months from the claim being made.

This is a significant reduction in medical expenses, especially as most workers require new hearing aids etc. past 12 months.

You should therefore ensure that you obtain all the treatment you can within 12 months of your claim being made.

Weekly wage compensation
For most workers, such benefits have increased in the amount per week (cap) but decreased the duration of the entitlement to such benefits.
For most workers, this benefit will be limited to a period of 1 to 260 weeks.

If a person is seriously injured and receives an assessment of or in excess of 21% Whole Person Impairment, those benefits may extend from 261 to entitlement to the aged pension.

Permanent Impairment Benefits
One and One claim only can be made.

If your condition gets worse – you are unable to claim a ‘top up’.

Further, compensation for pain and suffering is no more.

You must have an 11% WPI or greater rating/assessment before you’re entitled to any permanent impairment compensation.

Seriously injured – the exception
If you have a 31% WPI or greater then, your entitlements to weekly wage compensation and payment of medical expenses will continue similar to before.

What should I do?
If you made a claim for compensation before 18 June 2012 and have not yet received permanent impairment benefits or feel you condition has become worse since you last assessment, please contact our office to arrange an appointment as soon as possible.

How To Make a Workcover Claim

 

The workers compensation system is run by the WorkCover Authority of NSW.  WorkCover NSW is a statutory authority within the Minister for Commerce’s portfolio. The primary objective is to work in partnership with the New South Wales community to achieve safe workplaces, effective return to work and security for injured workers.

Find out more about your eligibility to make a claim, claim application steps and all relevant information by reading our full workers’ compensation claims guide.

Workers Injury Management Guide

Injury management is the prompt, safe and long term return to work of an injured worker. It attempts to include the treatment of your injury, rehabilitation back to work, retraining into a new skill or new job and liaison with your employer.

Everyone involved in your claim is required to cooperate and participate in injury management including the insurance company, employer, yourself and your treating doctor. Both you and your employer have responsibilities and rights in relation to injury management. Find out more by reading our complete guide to injury management.

Can I Sue An Employer?

The New South Wales Worker’s Compensation Scheme is a State Government funded scheme.

As a trade-off to having to prove fault, the scheme gives employees the right to compensation for injuries suffered caused by their work.

Am I eligible to sue?

An injured worker can still bring proceedings against its employer for their loss of wage/earning capacity in negligence, breach of a statutory duty or contract if the following can be established:

  1. That your injures suffered as a result of your employment have caused you a 15 % Whole Person Impairment or greater;
  2. That your injures were suffered because of your employers negligence;
  3. You have suffered some form of economic loss that is a loss of wages and or diminution of your earning capacity.

Explore more about what suing your employer will compass and gain additional insights by reading a past workers’ compensation case.