Workers Compensation Claims Guide for Injured Workers in Australia


Workers compensation is a compulsory insurance for every workplace in Australia whose sole purpose is to protect workers in case of an injury or impairment. Workers compensation is based on a no-fault scheme, which means every employee or worker suffering injuries in the course of employment can benefit regardless of negligence. Workers compensation can be claimed by workers suffering work-related injuries even if the injury did not occur in the workplace. Although the workers can claim workers comp regardless of negligence, application for work injury damages can also be made if the injuries or illnesses resulting from an employer’s negligence.

Claims for Workers Compensation can be made individually or with legal representation. Fortunately, even if the injured worker demands legal aid, no cost will be charged to them. This includes disbursements and lawyer fees. Workers Compensation Independent Review Office – WIRO supports the workers for their claim in workers compensation cases and covers the legal costs as well as paying to the lawyers representing workers.

What is workers compensation?

Workers compensation is the mandatory insurance for every workplace in Australia regardless of state and territory that covers workers in an event of work-related injuries. Employers have obligations to support workers throughout the claim process have responsibilities to take to prevent injuries. If the employer fails to take preventive measures, compensation for work injury damages may be paid to the injured worker. Employers are obliged the support the injured workers by implementing supportive return to work programs, keeping a record of worker injuries, making the initial notification within 48 hours to the relevant insurer, providing the worker with a modified work program suitable to the health situation of the worker if the worker is eligible to return to work, providing the worker with a job in the same statute of pre-accident job. An injured worker cannot be dismissed for 6 months from the date of injury.

Also, immediate notification to the insurer is required if the workplace injury resulted in death or a serious injury or incident.

Injured Worker Entitlements

Injured or ill workers may be entitled to receive compensation including weekly payments, medical treatment expenses and rehabilitation costs, domestic assistance, dependency payments and work injury damages. The compensation you may receive will largely depend on the extent of your injuries and on your situation as every situation has its variables. The injured worker will also be supported by new employment assistance payments.

  1. Weekly Payments

Weekly payments will support the worker while of work due to injuries or illnesses and are based on the worker’s pre-injury income, earning capacity, the period of payments made, workers capacity to earn in similar employment.

  1. Medical Expenses

Medical expenses include compensation for almost every medical expenditure such as treatments by practitioners and surgeons, ancillary services, artificial aids, medications.

  • Domestic Care

Care services in relation to the worker’s incapacity to perform daily tasks and modifications to the impaired workers home and vehicle.

  1. Dependency Payments

Lump sum payment to the dependent of the deceased worker if liability was accepted by the insurer. The insurer is obliged to contact the family/dependents of the worker. Dependents can also be awarded funeral expenses.

  1. Lump Sum Payment for Impairment

Lump sum payment may be awarded in addition to the weekly payments and all other benefits (excluding dependency payments). Lump sum payment can be awarded to the worker if the injuries lead to permanent impairment with a degree of 11% or greater for the physical injuries. For primary psychological injuries, the threshold is 15% or greater.

Claiming workers compensation

Prior to making a claim, the worker should demand medical aid, as it should be. Then the claim process can be started with the initial notification of the injury. Initial notification can be done by the worker, a co-worker, the employer or even by a medical practitioner. The notification can be made verbally or as a written notification and should include personal information of the worker, employer, if known the doctor, information demonstrating the injury such as how it happened and what kind, the date and time of the injury and personal information of the person making the initial notification.

After receiving the initial notification, the insurer should start the provisional weekly payments or delay it by issuing valid excuses. The insurer should be provided with sufficient information and documents to be able to make provisional weekly payments. These medical documents may be the certificate of capacity or any other form of medical documents demonstrating the injury.

A workers compensation claim form should be completed by the worker with the necessary attachments such as the certificate of capacity, payrolls or other documents relating to your loss, injury and pre-accident earnings. Almost every document demonstrating the ongoing treatment process, or the treatment required will be needed throughout the process. Claim forms can be obtained from the insurers but it is strongly suggested to demand legal aid to fully understand your entitlements and process. Almost every document you can provide to support your claim will make an impact on the outcome. Relevant information such as witness statements (if have), health condition of the worker and the treatment required is among the documents needed in order to claim for compensation. A workers compensation claim form can also be obtained through the Insurance Regulatory Authority’s websites of relevant states.

Through the process, necessary and reasonable medical treatments can be appointed by the insurer if a worker demands. Prior to medical visits, the insurer should be notified and the treatment should be approved by the insurer otherwise the cost of the treatment will not be covered by the insurer.

During the claim, any document related to the health condition of the worker should be informed to the insurer. The insurer will file all the medical reports of the worker’s injury. The insurer might request additional medical documents signifying the work capacity of the worker and the insurer might also require the worker to attend medical appointments to have the injuries assessed.

Why do I need a lawyer to claim workers compensation?

Hiring a lawyer is not compulsory and the claim can be managed individually. However, for workers compensation claims, the plaintiff will not have to pay for anything if they choose to work with a lawyer. Lawyers representing injured workers during workers compensation claim should be approved by WIRO and they will be paid by them. Advantages of having a lawyer are almost uncountable in this situation. The insurer might request many more documents indicating your injuries and assessments. A lawyer will help you arrange the necessary documents and protect your rights if you encounter any adverse situation. Suffering severe injuries and impairment might have devastating results. The compensation you may receive will make a huge impact on your future financial safety.

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