What can I claim for a work injury? What type of WorkCover compensation payments can I receive?
Medical Expenses
You can claim all of your reasonable medical expenses including bills for doctors, medication, hospital, physiotherapy, chiropractic and many other types of treatment.
In some cases the Insurer can pay for home help or modifications to your home or car.
You can claim traveling expenses for visiting treating or WorkCover doctors.
Weekly Payments
Different methods of calculating weekly payments for time off work apply depending on your date of injury and are subject to a statutory maximum amount. The calculation takes account of your pre injury earnings which for a limited period can include shift and overtime allowances. For most current claims the following applies:-
If you cannot work you are entitled (subject to a maximum amount) to:
1. For the first 13 weeks - 95% of your pre-injury average weekly earnings.
2. For 14 weeks to 130 weeks - 80% of your pre-injury average weekly earnings.
3. After 130 weeks - 80% of your pre-injury average weekly earnings if you have no current work capacity which is likely to continue indefinitely.
If you can do some work you are entitled (subject to a maximum amount) to:
1. For the first 13 weeks - 95% of your pre-injury average weekly earnings less current weekly earnings; or if you have not returned to work because there are no suitable duties - 95% of your pre-injury earnings.
2. For 14 weeks to 130 weeks if you have returned to work - 80% of your pre-injury average weekly earnings less 75% of your current weekly earnings; or if you have not returned to work because there are no suitable duties - 80% of your pre-injury average weekly earnings.
3. After 130 weeks you can apply to the WorkSafe Victoria for weekly payments to continue if:
* you have returned to work.
* you are working at least 15 hours a week.
* you are earning $151 or more a week.
* you are incapable indefinitely of doing more work to increase your earnings.
In some circumstances you maybe entitled to weekly payments for a period of 13 weeks following surgery.
All weekly payments are dependent upon you:
(a) making reasonable efforts to participate in rehabilitation and accepting reasonable offers from the employer to return to work in suitable employment;
(b) attending the insurer’s doctors and/or rehabilitation providers for assessment.
Superannuation Contributions
Superannuation contributions are payable after 52 weeks and continuing while you are in receipt of weekly payments
until age 65.
Lump Sum Compensation
Impairment Claims for injuries on or after 12 November, 1997
1. If your work injury causes a permanent physical whole person impairment of at least 10% (or 5% for certain injuries sustained from 3 December, 2003) you are entitled to a lump sum impairment payment. For a psychiatric injury impairment must rate at least 30%. The maximum impairment entitlement is approximately $503,000.
2. Impairment is measured using an American medical publication known as the AMA Guides Fourth Edition. It generally cannot be assessed until at least 12 months from the date of injury and only if your injury has stabilised.
3. If the work injury caused a total loss of a body part (eg, amputation of the first joint of a finger) lump sum compensation may be available even if the whole body impairment is less than the 10% or 5% threshold.
4. To make a claim you need to complete and lodge an impairment claim form. Galbally & O’Bryan can advise and assist you with this. Contact a WorkCover compensation lawyer
5. Payment of lump sum compensation for permanent impairment does not affect your entitlement to weekly payments or payment of medical and like expenses, or prevent a work injury lodgement (if appropriate) of a further workers compensation claim for common law damages for a serious injury.
Suing for Negligence - Common Law
If you have sustained a ‘serious injury’ as a result of the negligence of your employer or another party you may be able to
sue for substantial compensation called ‘damages’. This can be for pain and suffering only (general damages) and also in some cases for loss of earnings.
An application for a serious injury certificate needs to be made to WorkSafe Victoria or Court.
You are deemed to have sustained a serious injury if you have a whole person impairment of 30% or greater. If your impairment is less than 30% the Insurer or Court will grant a serious injury certificate if it is satisfied that you have sustained either:
• Serious long term impairment or loss of body function; or
• Permanent serious disfigurement; or
• Severe long term mental or severe long term behavioural
disturbance; or
• Loss of a foetus.
The injury’s impact upon your enjoyment of life is looked at to determine if you have a serious injury so to be able to sue for pain and suffering compensation. In order to claim compensation for loss of earnings you must show you have sustained at least a 40% permanent reduction in your earning capacity.
The process of making an application for a serious injury certificate is complicated. We are happy to meet with you to explain the process and if appropriate Galbally & O’Bryan can prepare your application.
In rare instances you can sue a party, other than your employer, for damages even without a serious injury.
A common law claim must generally be lodged within 6 years of the date of injury otherwise your right to sue may be lost.
Fatal Injury Claims
If employment was a contributing factor to a worker’s death a claim can be made by a financially dependent partner
and/or children.
The dependents are entitled to lump sum compensation plus a weekly pension. They may also sue any negligent party.
Other Claims
Income Protection /Total and Permanent Disability Claims
If you have superannuation and as a result of injury or illness have been rendered totally and permanently disabled you may be entitled to a lump sum benefit from your superannuation fund. Payment of any superannuation benefit can affect your WorkCover entitlements. In certain circumstances you may also have other personal insurance which entitles you to compensation if injured.
Galbally & O’Bryan's WorkCover Compensation Lawyers can provide advice on these types of claims.
