Insurance companies messing with the lives of injured workers-share your stories!

injured-workers-story

“It’s under investigation”  Delay, delay.  “We are waiting on some records.”  More delay.  “It takes a while to process your information in our system.”  “We’ll let you know when we make a decision.”  “I’m sorry you haven’t gotten your weekly pay, I’ll look in to it.”  More delay…. Does any of this sound familiar to you?

Insurance companies messing with the lives of injured workers-share your stories!

Since our existence (about 2 years ago) we’ve definitely noticed an incredible up-rise in workcover insurance companies messing with the lives of injured workers…and for no reason.  They aren’t approving necessary surgeries even though every doctor and/or specialist says it’s really needed.  They’ll pay for physio, but not for an MRI.  They’ll pay your medical bills, but not your weekly pay, or the other way around.  They won’t pay anything at all.  They won’t return your phone calls.

It seems to be a new and even more pathetic and aggressive strategy to try and frustrate injured workers.  It’s not that there haven’t been unreasonable delays on prior thousands of cases, it’s that the amount of times that it’s happening has greatly increased.

And it doesn’t matter how strong your case is or how weak your case is.  They are just being ruthless.

The silver lining is that many injured folks have had some great success in getting these denials turned around once their lawyers have been involved, but on some cases injured workers have had to go all the way to trial (court) when there doesn’t appear to be any valid reason for them disputing your care or benefits!

So it’s not that you can’t win, it’s that they’ll put a  big hurting on you if you don’t have a savings or others to rely on.  In turn this can make your medical condition worse because the stress of it all can and will obviously lead to further problems.

We are monitoring this closely.  The best thing we can do on our end is be very stern and stubborn and to publish if something unreasonable happens with any injured worker, in order to continue to send a message that they won’t make any case easy.

In fact, we all need to send a message back that if you mess with injured workers and/or break the law, it will not be tolerated, and this includes YOU!

However publishing injured workers’ stories on our and like-minded sites isn’t enough, and as MP David Shoebridge says, it is well and truly time the  government heard directly how the harsh workers compensation (changes) are impacting real people’s lives. 

Whether you live in Victoria, QLD, SA,… or NSW, it is really time to engage beyond blogs, websites and forums, i.e to write to your (local) MPs (for starters) and bring your workcover nightmares to their attention. Ensure your New Year’s resolution(s) include at least one letter to an MP, (and copy your letter to aworkcovervictimsdiary who will publish it!).

If you live in NSW, Finance Minister Andrew Constance says that if there are cases where people have been treated unfairly as a result of the changes to WorkCover, then he will look into them personally.

Is your case one of them?

Regardless… we believe every injured worker should be writing to the minister!

Do you have a WorkCover story? (NSW)

12 Dec 2013 – MP David Shoebridge (NSW)

It has been over a year since the O’Farrell government’s savage cuts to workers compensation passed the NSW Parliament and as a result many seriously injured workers have lost some or all of their benefits. The changes have saved the government and businesses money, but in doing so have comprehensively failed to protect the rights of injured workers.

It is well and truly time the NSW government heard directly how the harsh workers compensation changes from 2012 are impacting real people’s lives.

To help make this happen we have developed this online survey that we will use to send your stories of WorkCover injustice directly to the finance Minister Andrew Constance.

My office has heard countless stories about the impact of this disgraceful legislation.  Most recently we raised with the Finance Minister the very real impact on a worker who had his lower leg amputated after a work injury.  Remarkably under the new system he was found to not be sufficiently injured to get life-long protection under the broken compensation system. (He was assessed at only 28% WPI ! – see more on ABC Video Source: ABC News The State Government admits new workers compensation laws need work

After bowing to pressure to fix this one worker’s case, the Finance Minister promised to personally investigate other cases where people have been treated unfairly by WorkCover.  We think that it’s time you told him your story.

[Source: http://davidshoebridge.org.au/2013/12/12/do-you-have-a-workcover-story/]

Again, a great thank you Mr David Shoebridge for standing by and standing up for injured workers!

This certainly isn’t over and bears watching in the coming months.  We’ll report more as we see things develop.

If you’ve had something similarly disgraceful happen to you, we’d love to hear your story.  And of course, if you need any help please let us know.

 

[Posted on behalf of workcovervictim who dictated the commentary]

 



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11 Responses to “Insurance companies messing with the lives of injured workers-share your stories!”

  1. Write a letter to the utter useless turds, fuck here i am malingering sponging of the system why rock the boat the new turd who took over pissy Pearce’s job he’s the type that’ll piss in the wind like boof the system needs work the turds say ,it need the kiss factor “KEEP IT SIMPLE STUPID” but the dumb fucks who hang out for the big pay when they retire for their services to the state these wombats wouldnt know jack shit they cut everything tafe firey’s and of coarse workers comp and cause they havent got the stomach for a big job they hand it over to criminals ,fraudsters and. thieves.
    My lovely lot ALLIANZ dont know how to answer phones reply to emails reply to letters and the best bit they dont even know the legislation mmm sorry the computer that spits out letters does know the legislation to me if these fucker’s dont know how it works how in fuck do fools like O’farrel and Constance know and in the age of computers im still waiting on replies from Allianz ofarrell and the fucktard constance and a host of others fuck em I’m of to malinger im good at it Allianz tell me im the best
    good to have ya back poo baa

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  2. I made this exact call, on this website, a couple of years back, and was publicly shamed for it. Glad to see you’ve finally seen enough of the corruption to publicly call for political action. Well done.

    Ben.

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  3. i had them cut my income off over the xmas period, when i tried to contact them they would not answer the ph or some one said they would call me back,They never did , my doctor had to call them Funny how they would answer the phone call when He rang, The next time they did this again over the xmas period, when they are on holidays, i was told after weeks of trying to contact them and no returned calls, that i did not send in my medical from, I again went to my doctor and asked why he did not send it . He called them and the excuse that was given , mind you this was asap, that they took it off computer and hard filed it away,???? .

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    christine mckenzie December 21, 2013 at 3:24 pm
  4. This survey is all well and good but it is only for NSW we need it done for all states.

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  5. Hello

    I have been reading this blog for some time now and found this report very interesting.

    I would like some advice from anyone who has been cut off from a Workcover Psych claim by an IME’s opinion, and how they appealed.

    I am a white collar single female professional who was sexually harassed, bullied and threatened by the owner of the firm I was employed by.

    I was on Workcover (NSW) for 6 months, then after seeing an IME ‘hired gun’ I was told my PTSD and associated anxiety and depression did not exist, and he also made a diagnosis of a completely bogus condition (BPD).

    This led to further depression – essentially as a result of this IME’s opinion, as my payments were cut off, false accusations and a false diagnosis, and dismissal of what had been a very traumatic event for me. I have most recently been diagnosed with PTSD and melancholic depression.

    I cannot go back to work for that employer, as the harasser still owns the firm, and I cannot work in that industry / job role as my PTSD is triggered from similar environments and work tasks.

    I have been scheduled to see another IME in 2014 for an independent decision.

    My lawyers are appealing the IME/insurer’s decision in court in 2014, but I have been told by my lawyers to start to find alternate work and study as soon as possible so it doesn’t look like I am a “leecher”.

    I am commencing full time study in February 2014 so I can retrain to have a new career by 2015.

    My lawyers are still pushing me to find work as well as study, to ensure I have mitigated my losses. However, I firstly do not have the capacity (I barely have the capacity to study), and I find my work experience (all corporate) is not making it easy to find night work i.e waitressing, bar work.

    Does anyone else have experience in appealing claims and have they studied/worked in the period leading up to a claim appeal? Have you had similar advice from your lawyers?

    Any advice you can give would be most definitely appreciated.

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    • @Confused, take your lawyers advice and cut your losses and try and move on. I know its probably not the answer you wanted to hear but unfortunately when it comes to psych injury claims that’s the best thing you can try do for yourself. Psych injury claims are notoriously difficult to get accepted in the first place let alone remain on for any significant period of time. If your psych claim is accepted, 6 months seems to have now become the “magic” number/maximum period of time before you are cut off. I am only guessing but I suspect the “standard view” now held must be that 6 months is more than sufficient time for most psych injury to have resolved. Anything beyond the 6 months then non-work related factors are deemed to now be the cause.

      Furthermore, courts/tribunals that hear appeals of rejected psych claims or terminated psych claims are now clearly taking a far more critical evaluation of psych injury claims, thus making a workers chances of having the rejection of their claim overturned or having their benefits reinstated particularly difficult.

      Your lawyer is correct, you are obligated to mitigate your losses. Understandably returning to your pre-injury employer is not an option given the circumstances, so that makes it incumbent on you, if you are not 100% incapacitated, to seek employment elsewhere or retraining in order to do so.

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      • @Confused (and interested people), Madame Zena is spot on – Courts look unfavourably upon injured workers -even those with the tiniest bit of work capacity (even 1 day a week)- who do not, or did not attempt to move on with their life in terms of returning to work. Needless to say that the defendants (workcover insurer lawyers and barristers) will also use any argument possible to demonstrate that you, the injured worker, did “nothing”, or not enough to mitigate your own losses, for example by refusing medical treatment (to some degree) rehabilitation, counseling, vocational assessment(s), seeking employment within your restriction(s), re-training, etc. You can read more about mitigating losses here>>

        Depending on your work capacity and the success at having your claim appealed/re-accepted, you may be entitled to some or the full cost of your retraining, as this will be seen as part of “rehab” and is an entitlement.

        Listen carefully to your lawyer(s) as to optimise your chances at success and be realistic. Learn as much as you can about the NSW legislation re psych injuries, read legal case studies and this site …

        Try not to worry too much about the one grossly biased IME and his/her report, all too common to all of us. Provided your own treaters and specialists (i.e. psychiatrist) submit ample supportive evidence of your diagnosis and causation, you stand a good chance at appealing your case. Just be prepared for a long and pretty much dehumanising process…

        keep in touch – we’ll keep you sane 😉

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        workcovervictim3 December 22, 2013 at 4:56 pm
        • @Madame Zena and @workcovervictim3 – thankyou, your honest advice is appreciated.

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          • Even though You solicitors have told you to cut your losses. It still remains unlawful to sexually harass in the work place. Depending on the situation equal opportunity can advise an avenue. Every good Registerd nurse will tell you that if a Dr make a bogus report then it should be reported firstly to that Dr that his information is incorrect. Give them time to alter the report. If they refuse, report them to APHRA. False diagnosis is a serious breach of medical practice. Not enough IME’s are reported. You do have a voice.

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  6. I agree that people need to tell their stories in a safe trustworthy environment. With all the stories gleened by this blog over the years, the addition of a few more should give enough ammunition to commence actioning change in a very short time. Well worth watching what will happening in the new year.

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  7. Messing with injured workers is how they increase profits.
    Your average claims manager is under constant pressure to deny a certain percentage of claims each month and to delay as many claims as possible for as long as possible or as seen with QBE in NSW recently have your job exported to Phillipines. The more pending claims they have in the filling cabinet the safer the job is. There is also the not so small matter of profits for insurance companies.
    When it comes to delaying tactics QBE’s claim managers in WA are some of the best in the country which is why most of them kept their jobs while NSW jobs moved to Manila. To be fair to NSW case managers the workcover laws in WA makes it easier to delay claims and screw around with injured workers and have taxpayers foot the bills, something you can look forward when they eventually change the rules again. The insurance companies are there to make money for its shareholders and pay directors millions in salary and bonuses for attending all 12 meetings during a year not to provide support to injured workers, pay them wages, medical and rehabilitation simply because they were injured on the job. After all the accident could have happened at home and is only through bad luck it happened at work, if you want to be paid you should pay for your own income insurance which they would be happy to provide for a small fee. According to a QBE case manager here in WA if you are unable to return to work because of your injury and not able to provide for your family you should seek assistance from Centrelink. I guess it was good advice because it can take over a year before you can put your claim through the Workcover arbitration system to have it decided thanks to insurance companies clogging up the system intentionally to increase their profits and cover losses made by bad investment & insurance decissions overseas.
    Under the current laws in WA a creative claims manager can use the missing documents excuse to delay making a decission on the claim indefinitely unless the worker applies to Workcover for a decission. Even then before an application for arbitration can be lodged the worker first needs to apply and attempt concilliation with the insurance company. The claims manager can easily delay and postpone concilliation meetings for months by submitting lies to Workcover and calling to cancel concilliation meeting using the “missing documents” excuse. Meanwhile the worker get no wages but has to pay for any medical expenses, bills and mortgage out of his own savings (if he has any otherwise it is up to Centrelink to help him survive ) so it keeps him “motivated” to return to work asap even if not fully recovered. But because the claim is in dispute the insurance company does not have to pay for rehabilitation or a return to work program so the employer is not oblidged to provide any work to the injured worker.
    A few months later when concilliation procedings are exhausted and there is no resolution to the dispute a certificate of outcome can be finally issued to the injured worker which allows him to apply for arbitration. If the injured worker was silly enough to believe the bullshit on Workcover’s website and did not hire a lawyer because he believed in amicable resolution of the dispute at concilliation he now has 30 days to find a lawyer, bring him up to speed and apply for arbitration.
    Now the application for arbitration is lodged but up to 6 months have already passed since the injury date and last time the injured worker got paid any wages so there is a good chance he has already ran out of savings, debt collectors are chasing him for unpaid medical expenses, MRI scans, etc. which the insurance company refuses to pay for and the only money coming in is the Sickness benefit from Centrelink and only medical treatment comes from the local GP who bulk bills Medicare for his services. Now the waiting game begins because insurance companies are intentionally clogging the system by denying as many claims as possible and don’t have to pay anything until the arbitrator makes a decission. The worker has to survive another 9 months which is the current wait for arbitration without topping himself or ends up in jail for running over the claims manager with the Karma bus. Insurance company continues to collect (increased) premiums from employer and does not have to pay a single cent to the worker for at least a year since the accident and the claim for compensation lodged. Near the end the insurer can decide to either make a low settlement offer (to the now almost certainly financially bankrupt worker) to have the claim closed, approve the claim and save some arbitration fees or have the claim decided by Workcover arbitrator and worse case scenario be forced to backpay the wages and statutory expenses. Since in WA there are no penalty interest rates for backpay of wages, and even the states that have penalties the rate has been recently dropped to insignificant amounts, there is no incentive for insurance companies to pay anything unless forced to do so. As far as the statutory expenses go the wageless and bankrupt worker would have kept them to minimum and well below what they would have been if the insurance was paying for medical expenses and rehabilitation of the worker. Whatever the insurance company decides to do after they have screwed with the worker for over a year it is a WIN-WIN-WIN for them with the only LOSERS being the injured workers and taxpayers. Not only are taxpayers forced to subsidise the injured worker for a whole year before the claim is approved but also after that if he has not recovered and the pitiful prescribed amount for wages is exhausted and injured worker ends up back on Centrelink.
    What is the point of having private insurance companies provide Workers Compensation Insurance if governments allows them to abuse the system and it is the taxpayers who end up paying the cost of injuries at work ?

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