Although a very short article, this painfully ‘funny’ story sums up what workcover really is about. Phil, a pensioned injured worker, who needs joint replacements, uses a walking stick. He needed to have his walking stick replaced… check out workcover Victoria’s response and the mind numbing process Phil had to go through…
Take a stick to workcover Victoria
Phil is a disabled pensioner and Victorian WorkCover pays most of his medical bills.
Phil uses a fold-up walking stick, but they wear at the joints and have to be replaced.
“I rang WorkCover to inquire about a new one and was told I needed proof, so I said my brother is an engineer and he would examine it.
“They said a doctor had to approve the condition of the stick, so they paid for a trip to a doctor.
“The doctor said he knew nothing about walking sticks, but after being charged $150 plus his normal fee for the visit, he said he’d let them know that I needed a new one.
“I now have a new $19.90 walking stick.
[Source: http://www.heraldsun.com.au/ipad/take-a-stick-to-workcover/story-fn6bn88w-1226375568450]
This story makes me think of a previous article we wrote about surveillance and case managers – some case managers will request an IME (independent medical examiner) to assess the “wear and tear” of for example your prescribed crutches or walking stick/cane, for the sole purpose of gathering so called ‘evidence’ on whether you are really “using” those devices and whether you “really” need them. How SICK!
A few months ago, an injured worker shared his story about the end cost of a pair of thongs – a simple $10-20 pair of thongs, prescribed and reasonable for his injury was denied at all cost by his insurer. The matter went to conciliation and in the end the total cost of the pair of thongs exceeded $3000 just in conciliation fees (incl. the cost of a dozen medical reports)!
Reflecting back on my own claim, I can’t help but wonder why workcover (Xchanging in my case) happily forks out thousands of dollars in an attempt to deny me legitimate,prescribed and medically reasonable entitlements such as basic home help, personal care, taxi transport to medical appointments etc. Consider for example that Xchanging paid $7500 (at least) in an attempt deny me basic home care – about $2500 was spent on Conciliation (incl. the cost of all medical reports) and a flat fee of $5000 was spent on the Medical Panel. Now, think how much home help $7500 could have bought me (or any other injured worker in dire need of this service)?
Needless to say that my case for basic home help was rapidly awarded at ACCS, however the whole process took me over 11 months. And whilst I was awarded 2 hours per fortnight home help at Conciliation, I felt that this was not nearly enough for a severely disabled person like myself. So, there was no option for the Conciliator than to refer the matter to the Medical Panel and ask the question on whether I could (please) have 2 hours of home help per week rather than 2 hours per fortnight. A Medical Panel referral costs the insurer a flat fee of $5000 and this does NOT include the cost of all medical reports.
I am unsure how the actuaries work out profit versus loss, but I imagine that by denying and stalling legit entitlements to injured workers, they rely on a certain percentage of those injured workers to literally give up their pursuit for (legit) entitlements – SSS – Stall, Starve, Settle concept. Wear injured workers down, bully, harass, intimidate them, use endless “paperwork”, demoralise them, don’t inform them of their rights, then starve them (literally – cut off benefits) and eventually, for those that still have the energy to fight, “settle” for half the legit entitlement (i.e at conciliation) or else, continue the fight (i.e. Medical Panel or court).
A few tips
Our advice is simple and that is not to give up any of your legitimate entitlements, no matter how “small”. KICK BUTT and pursue your rights. If you feel you can’t handle the stress of it all, seek help and support. For example, many injured workers appoint an ‘advocate‘ to deal with it all (this can be a family member, friend, even your psychologist, a professional workcover advocate or your law firm).
You can also request that all correspondence is made in writing and sent to your [advocate, doctor, lawyer] and that no contact is made directly with you. (see our tips collection for sample letters).
We also advise you to use the service of WorkCover Assist [if you are located in Victoria]. These ‘consultants’ are extremely well trained and versed in the legislation and will fight to the death for your rights at conciliation.
Shortlink: http://aworkcovervictimsdiary.com/?p=9127
Hi Phil
Again, it reminds me of the young German Coast Guard trainee
http://www.youtube.com/watch?v=gh5xu35bAxA
Is it lack of experience or commonsense? Both! And there definitely seems to be a language barrier.
You ask “Am I mad, or is it the system?” Here’s a clue – you’re not mad!
Yeal, LOL, what are they S[th]inking about? But I do wonder whether they base all these nonsense on actuaries (calculations) or whether they’re just plain DUMB?
Lol I obtained some footage from WorkCover which highlights why they are having communication problems – apparently insurers operate the same way.
http://www.youtube.com/watch?v=kLm8d05D0zI
Now we know why there are so many problems.
This footage cracked me up- had to post the video – surely looks like my workcover agent’s office
What these case managers get is bonuses for their performances. Or lack of . When you ask these people in writing to forward any future correspondence to your doctor etc and no further contact with you at all you will receive either a few calls from the case manager’s ” manager ” or they will send a letter to you attempting to make you change your mind. Do not answer any of these and forward them onto your doctor, solicitor etc as they are in serious breach of the conditions that you are allowed. You may receive a letter from your employer as well and set the same conditions for them as well stating that they are not assisting you with your safe return to work . Your employer may want to meet with you to discuss these issues. Don’t. Send them a letter stating that you will meet a representative of the employer ( risk manager ) , your doctor, your psychologist / specialist , your case manager and yourself in your doctors rooms or psychologist/ specialist rooms to discuss your safe return to work conditions. It is all about your safe return to work !!! That is up to your own medical team and in particular your medical practitioner who has a lot of say as it is he/she that signs the WorkCover medical certificate and signs the final WorkCover medical certificate when you are fully recovered !! The WorkCover medical certificate is a legal document !!
Hi Minnie, just in regards to yr last comment. medical certificate a legal doc.. hmmm apparently not in my case. I have 9moths of med certificate’s unfit for work, not receiving anything after 130 wks. And my lawyer says i can work.. Lawyer thinks he is a Dr too,LOL.
Hi Tara .
The WorkCover medical certificate that your doctor signs and also it has on it if u are unfit for work/ fit for work on restricted duties.Has your doctor ever changed the conditions on this document ? Also have u been to see a specialist that your doctor sent you too for workers compensation ? It would be an idea to get two specialists with your work related injury involved . It seems you also may need a new lawyer as my understanding from a legal source that informed me the WorkCover Certificate is binding . Also contact your state WorkCover office in writing or email to the Chief Executive and state your what is happening .
Hi winnie , thanks for the reply. medical certificates was changed a few times, light duties,with restriction, had surgery already, up to common law case.have 2 injuries,2 claim numbers. had a xray,mri need surgery again,bn on unfit for work since then. such a long story..
Yeah that’s what i thought, should b a legal doc,but lawyer and barrister don’t think so.
Im with the biggest law firm in aus ,who don’t seem to care about little ppl.what would happened if i changed, its a no win no pay.Omg so pissed off right now, feeling like telling everyone Workcover/agent/lawyer to get f**ked.
Workcover suxs .
Hi Wannie
An extract from the transcipt from the NSW Workers Comp Inquiry, much more was said on this and other related issues:
Mr McPHILBIN: Can I give you a headline? I think that the system from the beginning is very, very adversarial. It is very hostile and it is all about reducing cost and this is what is causing the problems. I know from the very first day that I had a claim I felt like I was under siege. I was treated like I was fraudulent, like I was trying to rip the system off. Every injured worker I talk to feels exactly the same way.
Mr MICHAEL DALEY: Who was that from? Was that the scheme agent, or who imposed that feeling on you?
Mr McPHILBIN: It can come both from the employer and definitely the scheme agent.
MR SMITH: Workplace harassment.
Mr McPHILBIN: Yes, it is basically. You feel as if you are being bullied and harassed and treated as if you—you come to doubt yourself.
I believe that I have a very strong case against previous NSW government ministers and others concerning their total lack of transparency et al in dealing with my correspondence from my workers compensation case. To this day I have had no transparent answers to my many relevant questions as to why I received many intimidating and threatening correspondence both verbal and written by my employer and manager . One particular written correspondence by a certain person they had diagnosed my condition and used this against me . This person was asked if they had a medical degree, a psychological degree or psychiatric degree in relation to my condition. This person was removed after a WorkCover representative intervened. This is typical of how ruthless employers are in attempting to cover up issues . Like the majority of case managers mentioned on here and employers they also have a code of ethical behaviors that are mandatory under the policies and procedures they are governed by.
The Cos Magazine Daily (a very popular Canadian OHS magazine) has indeed a flair for picking up relevant stories and kindly published our article! Check it out: http://paper.li/cosmagazine
Thank you to the Cos Daily again – your support is invaluable to us!