Workcover NSW cuts hurt injured workers

Workers-Comp-Butcher

Many people injured at work who have been receiving ongoing medical payments through WorkCover NSW have recently been shocked to receive notices saying it will end on 31 December.

 

Workcover NSW cuts hurt injured workers

The changes are part of harsh changes to the WorkCover legislation brought in by the NSW government that are starting to bite.

Only those who have catastrophic or extremely severe injuries will continue to get their ongoing medical bills paid under Workcover NSW. This could include people who have lost a limb or have severe spinal injuries.

Entitlements are based on impairment percentages which themselves are somewhat confusing.  Those under the 30 per cent threshold will have to undergo work capacity assessments.  These are determined by the insurer.  The right of appeal to the Compensation Commission is now gone and the workers legal costs in respect to work capacity matters are no longer covered.

The government last week announced a $309 million surplus for the WorkCover NSW scheme, hailing it a great result for employers and jobs.

“This is at the expense of the injured workers who are being hit hard by these cruel changes to WorkCover,” said Kieran Fraser, president of the Injured Persons Association.

“The insurance companies now call the shots as they decide whether a worker is injured enough to receive payments. If they cut payments to injured workers then of course their profits will go up.

A review of WorkCover NSW is proposed for 2014, and Mr Fraser urged injured workers and their families to join the IPA in pressing the government to modify the changes.

Mr Fraser said injured workers were now fearful of losing their finances as well as having their lives ruined by their work accident.

“A doctor told a woman who needs an operation to reduce pain that she might have to do without the procedure as insurance will no longer pay for her ongoing care,” Mr Fraser said.

“People who have prosthetic limbs won’t be able to replace them when necessary. All entitlements to medical expenses are being cut off after 12 months from the date weekly payments cease.”

This comes on top of abolishing lump sum compensation for impairment unless the victim’s impairment is greater than 10 per cent. This includes industrial deafness, most back injuries and even shoulder reconstructions. Compensation for pain and suffering has been abolished.

However other legal avenues may exist for an injured worker to pursue compensation or damages for their injuries. It would be wise for people injured at work to seek advice from a specialist lawyer experienced in the field.

 

[Source: http://www.mondaq.com/australia/x/275044/Employee+Benefits+Compensation/Workcover+cuts+hurt+injured+workers+in+NSW]

 



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9 Responses to “Workcover NSW cuts hurt injured workers”

  1. Kieran Fraser the most pro insurer case manager in this business telling injured workers to join his organisation?

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  2. Record the name of everyone involved in work capacity decisions and their roles in this. Work capacity decisions are not part of Workcover anymore as we cannot challenge the decision. This means that untrained people are making arbitrary decisions overruling medical certificates and essentially practising medicine without a license. I smell a lawsuit coming on.

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  3. I have just been advised by my self insurer that I will require a work capacity and vocation assessment.
    My compensation was decided by a tribunal ( NSW ) before the changes but now I am so worried they are going to try and get out of it. I desperately need the money because I can only work 2 days a week.
    Due to my stress is there any way I can delay this and can anyone give me some tips on what to expect.
    Also they want to come to see me as opposed to me going to see them.
    Thanks

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  4. Joan, if you can, I would seek legal advise on this (try Turner Freeman or any other reputable compensation experts). If the Tribunal awarded you the compensation then you should be able to get a judge to overrule the work capacity decision, however you may need to wait until the Goudappel decision in March. I would also see your treating doctor about the stress this is causing you as a matter of urgency.

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  5. The first thing to do is to get an appointment with your treating doctor to get him/her to put in writing the reasons you are working two days per week, particularly if working more hours has the potential of exacerbating your injury. You also need referrals to your specialist and any mental health professional to support your mental health and provide accurate reports on your work capacity. If your pain levels are such you are on pain medications and this effects your ability to work you need this in writing. If you have mental health problems you need medical evidence on how this effects your ability to work. You need all the evidence you can get to support your claim if it is denied. You can’t dispute the insurer’s work Capacity decision with a solicitor but you can ask for an insurer review as well as a WorkCover review so your own evidence is essential. The insurer is meant to take into account your age,education/training and whether you are at risk of exacerbating your injury if taking on more hours or a different job so you need your doctor to state this. As for someone coming to your home tell them you will not agree and will see someone in their office near to your home. You may have no witness while at home either and how can they carry out proper testing of your functional capacity in your home. This is meant to be work capacity so they need to determine your capacity to carry out work related tasks. All they will do is spy on you and report back to the insurer as well as this they will then know where to send the private investigator who will then provide selective evidence to make you look fraudulent. Unfortunately the whole system has become adversarial with workers fighting for their lives and livelihood. Sadly if you are working less than 15 hours you will be discriminated against and they will deny your claim. Make sure you write down all medications and their side effects and how this impacts on you work capacity. Record all things that effect your work such as pain, further injury, anxieties, depression, physical restrictions, not able to drive distances etc so you do not miss anything. You are not expected to do menial work and your work capacity must be suited to what you are trained for ie they can’t say you can do brain surgery if you are a mechanic or the opposite and they can’t tell you you can get a job dusting as this comes under cleaning and if you can’t do all the aspects of a job you can’t do the job particularly if you are a nurse or electrician. One trick the insurers use is to say the person who is a physical laborer is fit for office work which fails to respect the fact office work is highly specific work and these days requires significant computer skill and specialized knowledge. No one can just do “office work” People need training for office work and this is different for each industry so if they suggest this get them to be very specific about how you will do this and what training they will pay for so you can get the qualifications. Call WorkCover 131050, claims assistance to ask if you can be forced to undergo this work capacity testing in your home. If you have a choice, and I’m sure you do, then say no!! These people get paid a lot more than you so they can provide their own office.Always have a witness as well as you may need to make complaints at a later stage. If you are sent to an IME google or ask on this website for some information about them. Get busy and good luck.

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  6. Bunny is right as you should get a solicitor to determine if you can challenge the work capacity if you were hurt before the changes. What I meant was once they make the decision you will have to ask for an insurer review and WorkCover review and then a WIRO review and your solicitor will not be paid for helping you with this. There are solicitors taking this on without pay and giving advice so I would ask around for a good one. We traveled to Sydney to see specialist Compensation solicitors and they were very good. Just google one who does only compensation matters and negligence matters and will discuss your case without you having to pay them first. You did not say whether you have had a permanent impairment assessment and have a percentage of injury. Talk with a solicitor about this. The more medical treatment evidence the better and your solicitor will need this also.

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  7. Don’t forget you make get info and make a complaint against any scheme agent, self or specialised insurer relating to the operation of the Workers Compensation Scheme NSW, call the WIRO Complaints Team on 13 9476 or send an email to contact@wiro.nsw.gov.au

    http://www.wiro.nsw.gov.au/media/27460/2013___november_15____complaints.pdf

    The WIRO Complaints Team is able to answer questions and to assist where possible to resolve the complaint. To assist in communicating this service, WIRO has prepared a flyer for more information

    Read Here – http://www.wiro.nsw.gov.au/about/publishing/wiro-wire/

    FOR MORE INFORMATION

    Please contact:

    Kim Garling

    Workcover Independent Review Officer

    13 94 76

    contact@wiro.nsw.gov.au

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    workcovervictim3 November 18, 2013 at 2:55 pm
    • Thank you all for your support ( especially the detail from Complaint maker ) and if any one else can help please respond.
      I will try and locate a solicitor Bunny but even that is hard….. I have an 11% permanent impairment assessment however the the solicitor I originally used doesn’t seem too interested in helping me anymore.

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      • @Joan, also if not done already, we suggest you read the guides and fact sheets re work capacity assessment and decision listed on our FAQ workcover NSW. You may also want to get in touch with our friends at the Injured Workers Support Network for more info (i.e they have regular injured workers meetings , have a great rehab service provider etc)

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        workcovervictim3 November 19, 2013 at 8:46 am