A couple of days ago we received an email from a Western Australian injured worker who has clearly suffered a psychological work injury. His case was even mentioned in parliament! But guess what, folks, even though all the doctors he was made to see (including Allianz doctors) state he has suffered a workplace psychological injury, workcover WA and Allianz continue to dispute liability for his injury! Any advice, help would be greatly appreciated!
Allianz disputes liability for high profile psychological workplace injury
The injured workers story – his own words
All the Doctors including Allianz Doctor say I have suffered an injury, yet workcover WA and Allianz dispute liability, however No form 3B INSURER’S NOTICE THAT LIABILITY IS DISPUTED, has ever been lodged I have not been paid since [month] 2010.
Letter treating doctor X
Wow, this is an extraordinary story indeed and we find it very difficult to understand on what basis Allianz is disputing liability for this well documented and high profile psychological injury!
We are not familiar with the relevant workers compensation legislation of WA and hence an only guide you to the relevant documents and Acts (see below).
However, as applies for all workcover schemes in all states, there is usually a time limit for the insurer to either accept of reject a lodged workers compensation claim. For example in Victoria they have 28 business days to respond. It is normal practice for insurers that if they refuse liability for your injury they send you a letter to that effect (with the reasons as why your claim was rejected). This “rejection letter” can then be used to dispute (appeal) the decision. In WA it appears you can go to the Conciliation Arbitration to dispute a decision. The claim process, including the dispute process is well described on the WA workcover website.
It may be worth reading the WA Act in detail as it appears that you may fall under a difficult or even exclusion of “a worker” definition (i.e. contract worker). Some states have very strict and complex definitions on what a worker is and some people do not meet the criteria. It may be that WorkCover WA is disputing liability based on that definition…?
We would strongly advise you to seek immediate legal advice, given the difficulties you are having. If you don’t know where to start or go, check out Shine Lawyers, which also have an office in Perth. Initial consultations are free and they take on cases on a no win no fee basis. This is a good way to find out if you have a case and if you do to engage them (or any other reputable personal injury law firm).
We advise any injured workers to seek legal advice sooner rather than later! Unfortunately the workcover system is set up in such a way that you’re basically ‘lost’ and ‘walked all over’ without legal representation.
Apart from that, ensure you keep meticulous records from all your dealings with workcover and Allianz, as well as with your employer. Keep all communications in writing (email is fine) and keep a diary. Witnesses and witness statements are also very useful in cases of bullying.
Hope this helps a bit. Good luck and thank you again for sharing your story!
Workers compensation in WA
WA’s state government statutory authority responsible for the regulation and administration of the workers’ compensation system in Western Australia. See www.workcover.wa.gov.au
Who is entitled to pursue a Workers Compensation Claim in WA?
To pursue a Workers Compensation Claim in the state of Western Australia you have to be established as a worker by the insurance company and your employer. You also have to have sustained the injury in the workplace in Western Australia.
Workers Compensation Claim in Western Australia are managed by WorkCover Western Australia.
What are my limitations in WA?
To pursue a Workers Compensation claim you must report the accident to your employer straight away and see your doctor for diagnosis and treatment of your injury.
You must lodge your Western Australia Workers Compensation Claim within 3 years from your date of injury, if longer than 3 years you will not be entitled to make a claim and your claim will become statue barred.
What legal entitlements that I should receive in compensation?
After your claim has been accepted by WorkCover Western Australia, the entitlements that you may receive in compensation will include a percentage of your wages, and medical treatment approved by WorkCover. Please keep it mind that WorkCover Western Australia can cut your repayments significantly after a period of time while on Workers Compensation in Western Australia. WorkCover Western Australia may also pay for your medical, hospital and rehabilitation expenses.
When can I pursue a Common Law Claim?
To pursue a Common Law Claim in the state of Western Australia you need to have lodged you statutory claim through WorkCover Western Australia and has been accepted. To pursue a Common Law Claim liability has to be established that the accident was not caused by you or you were not at fault. You need to have sustained an injury that may leave you with a permanent disability and have incurred medical expenses.
Seeking advice about pursuing a Common Law Claim is definitely a positive and necessary approach to take as the insurance companies do not take your past and future losses into account and also pain and suffering which can be done in a Damages Claim.