WorkCover Minister replies to an injured worker – another empty content letter
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This typical “empty content” letter is yet another example of the, yes, hopelessness of writing to the workcover minister in the hope to obtain some help. Note that Gordon Rich Phillips merely refers to the sections of the “act”, adding “insult to injury”, in my opinion.
This is a major problem for many injured workers who, after 130 weeks, still have no work capacity (i.e. certificate of incapacity) and are to undergo, for example, further treatment(s) such as surgery. This leaves those genuinely (and often pretty severely) injured workers in an extremely difficult situation. They loose their weekly payments, have no income and are unable to work! Just because their injuries are not deemed to cause “indefinite” incapacity, they are CUT OFF weekly payments and totally marooned.The term “indefinite” is extremely difficult to interpret indeed. What medical doctor or specialist can state that someone’s injury will cause “indefinite” incapacity, duh? With daily advances in medicine and surgical techniques, who is to say that even the most severely disabled people may not be able to be helped at some stage? We believe this is a major legislation cock-up, because it leaves seriously injured workers unsupported after 130 weeks. No weekly payments even though you may be certified unfit for ANY work for months…
The injured worker also told us that she was made to attend a four week – one day per week – course by CGU as her “retraining” (so basically a 4-day course only). However, when she attended she found out on her first day that it was not even the course she had picked (and that CGU had agreed to). She – understandably- did not undertake this course. She then found out that CGU had made a “printing error” regarding this course, however the injured worker was NOT offered another (her chosen) course!
How does this work, CGU? Shame on you!
Update 21 August 2012 – read the follow up of the story here>>
http://aworkcovervictimsdiary.com/?p=8693
For more information about weekly payments in Victoria, consult the online claims manual:
http://www1.worksafe.vic.gov.au/vwa/claimsmanual/Entitlements%20-%20Weekly%20Payments_2.htm
Information about retraining (Occupational rehabilitation) is also available:
http://www1.worksafe.vic.gov.au/vwa/claimsmanual/Occupational%20Rehabilitation.htm
what a politician get something wrong
Question regarding the comment made ‘you remain entitled to reasonable cost of medical expenses for 52 weeks after the termination of your weekly payments’ Is this once the 130 weeks is up only? what about if they terminate earlier than that?
Mmhh, interesting question… According to the Victorian online handbook “Under all WorkCover schemes, the Authority or self-insurer will generally not be liable for payment of medical expenses after a period of 52 weeks from when weekly payments of compensation cease, except in certain specified circumstances (s.99(14)). A 28-day Notice must be given prior to such a termination.”
http://www.lawhandbook.org.au/handbook/ch18s03s02.php#Ch131Se58579
You can find the Act (VIC) here
So we presume this is after the 130 weeks, if you make it that far, unless you fall within the exceptions.
Insurers will always try to find an excuse not to pay for your medical treatment. Most often they’ll use “liability” issues, or state that your medical treatment is “unreasonable” In that case, you can dispute their decision by going to conciliation. The conciliator can then either rule (make a decision based on available medical info), or send you to a Medical Panel (for questions to be answered) and if that’s not even possible, they will issue you with a certificate of genuine dispute, allowing you to pursue the matter in a court of law (i.e liability for injury, additional injuries, medical treatment, even things like home help and taxi transport).
Hope this helps a bit. The law is certainly extremely complex and the insurers always seem to use the “fine print” as it were to complicate injured workers’ lives. I don’t know of a single genuinely and severely injured worker who had not a surgery delayed or denied and a medical and like treatment denied such as home help, couselling, and even physio. They also love their “utilisation reviews”, internally assessing whether you “benefit” from a treatment such as counselling, physio… and cut you off (he who has never seen you decides you do not need such and such, eh)
Yes its after the 130 weeks are up.
My physio was stopped in 2008,I need physio again 2010.New physio rang Cgu and get physio approved and I also got a Dr Letter.
After approving physio,Cgu LATER check file again.,they said they will not pay for physio.Went to accs just got another genuine dispute…yeahhhhhhhhh…But still have the physio chasing me for money..
Shame on you CGU….