In Victoria, it is compulsory for almost all employers to have WorkCover Insurance so that all full time, part time and casual employees are eligible to make a workers compensation claim in the event a workplace injury occurs.
If you are injured at work and, as a result of your injury, you require time off work or medical treatment, then you are entitled to lodge a WorkCover Claim to access workers compensation.
Following a work-related incident, notify your employer immediately upon becoming aware you have a work-related injury or illness and complete the register of injuries. This register must be kept at each workplace.
Further, you should seek medical treatment for your injuries as soon as possible. At your initial consultation, it is important to tell your doctor all the details and circumstances surrounding your injury.
After you report your injury and have your initial appointment with your doctor, you will need to complete a WorkCover Claim form and submit it to your employer.
If you need time off work and are claiming for weekly workers compensation payments or need to claim reasonable medical and like expenses, you should request a WorkCover Certificate of Capacity from your doctor. If you are off work for more than 52 weeks, you are also entitled to receive Superannuation benefits.
In addition to weekly payments and compensation for medical and like expenses, you may have further entitlements for lump sum compensation if you become permanently impaired.
In order to pursue a common law claim for monetary compensation, known as “damages”,, you must show:
- You have sustained a “Serious Injury” as defined in the WorkCover legislation; and
- Someone else, such as your employer or a third party, was at fault for your injuries.
In a common law claim, compensation may be claimed for pain and suffering and, in some circumstances, loss of past wages and loss of the capacity to earn income in the future for damages.
Strict time limits apply for lodging a common law claim. For injuries which occur in Victoria, you have six years from the date of injury to pursue a common law claim. In rare circumstances, such as only recently becoming aware of the seriousness of your work-related injury, this date can be extended. If you think you may be running out of time and are interested in pursuing a common law claim, it is important you contact a personal injury lawyer as soon as possible to discuss your options.
Lodging a WorkCover claim
To make a claim for weekly payments and medical and like expenses resulting from your work-related injury or illness, you must lodge a Worker’s injury claim form.
When you complete your WorkCover claim form, explain what happened to you and provide as many details as possible. Ensure all the injuries or illnesses you are claiming for are listed on this form and the WorkCover Certificates of Capacity.
Ensure you complete all the questions in part A of the Worker’s injury claim form and submit the claim form to your employer together with any WorkCover Certificates of Capacity, either by hand or post.
Your employer is required to complete part B of the claim form and send the completed form to the WorkCover insurer to be assessed within 10 days of receipt of the form.
Upon receipt of the claim and WorkCover Certificate of Capacity, the WorkCover insurer has
28 days to accept or reject the claim.
If your employer is refusing to forward your claim to WorkSafe, or if your employer cannot be located or no longer operates, it is possible to lodge your claim directly with WorkSafe or the WorkCover insurer.
Prior to making a determination on the claim, the WorkCover insurer will arrange for you to be examined by one of their doctors. This is known as an independent medical examination, and you must attend this appointment.
The WorkCover insurer may also arrange for an external investigator to investigate the circumstances of the injury and provide a report to them.
If the WorkCover insurer rejects your claim, you have 60 days from the date you receive the rejection notice to refer the matter to the Workplace Injury Commission for conciliation.
If your claim is accepted, you will be entitled to receive ‘no-fault’ benefits, which consist of weekly workers compensation payments and reasonable medical and like expenses.
Calculation of weekly compensation payments
Weekly payments are calculated based on your pre-injury average weekly earnings, which is an average of your earnings over 52 weeks prior to you sustaining your injury.
For the first 13 weeks of weekly payments, you are entitled to be paid at 95% of your average weekly earnings.
From the 14th to the 130th weeks, you are entitled to be paid at 80% of your average weekly earnings.
For the first 52 weeks of weekly payments, your pre-injury earnings include overtime and allowances. Weekly payments beyond 52 weeks do not take into account overtime and allowances in your pre-injury earnings.
Weekly payments beyond 130 weeks, are paid at the 80% rate of your pre-injury weekly earnings.
In the majority of cases, if you are incapacitated for work following an work-related injury, you will have an entitlement to weekly payments for up to 130 weeks. In some circumstances, an injured worker can continue to receive weekly payments beyond 130 weeks.
Compensation for reasonable medical and like expenses
You are entitled to claim the cost of reasonable medical and like expenses relating to the treatment of your work injury. This includes treatment from your doctors, surgeons, physiotherapists, medication and other providers and you may also claim the cost of travelling expenses to receive treatment, home services, or aids and appliances.
What is the time limit to lodge a WorkCover claim?
If you have been injured at work in Victoria, you are required to report your injury within 30 days of becoming aware of it. If you have sustained an injury in the past 30 days, inform your employer of your injury, seek medical treatment and complete a WorkCover Claim form within a reasonable period of time.
If you have sustained an injury more than 30 days ago, you should lodge a compensation claim as soon as possible. The fact that you have not reported the injury within 30 days will not necessarily prevent you from having an accepted WorkCover claim. In some circumstances you have more than 30 days from your injury to lodge a claim for compensation. Some of these circumstances include:
- You have many injuries which have developed over a period of time and are not caused by a single accident
- You sustained an injury, such as a repetitive strain, and you are not aware if it is work-related
- Your injury was initially a minor injury and got worse over a period of time
- You were uncertain that your injury is work related and did not report the injury
- You have recently become aware that you are entitled to lodge a WorkCover claim.
If you or someone you know have been injured at work and are unsure whether or not you are eligible to make a WorkCover claim, it’s important to seek legal advice as soon as possible. Speak to a member of our legal team to schedule a free, no-obligation initial appointment by calling our advice line on (03) 9321 9988 or submit an online enquiry today.
