In this post, we highlight the top five common mistakes injured workers make during the life of their workcover claim.
Most common mistakes injured workers make
1. Injured workers often talk too much
Answer all questions asked truthfully, but do not volunteer additional information about your life. Do not write extensive letters (or emails), or any letters to a workcover insurer/case manager more than a few sentences. Defer all questions about restrictions and limitations to your treating doctor(s) and all questions about your occupation/job to your employer. Answer all questions asked truthfully, then be quiet. We highly recommend you only communicate in writing. A workcover insurer can’t hold against you what YOU DO NOT SAY.
2. Failure to read the workcover law (in your state) and gain knowledge about your entitlements and rights.
Obtain a copy of your workcover law(s) as son as possible and know what you are entitled to long before sh*t hits the fan. By being able to quote sections from the relevant Act, you will be see a “different” approach by your case manager. S/he will go quiet, even apologise (sometimes) and even go as far as delay or cancel yet another IME. Learn as much as possible about the workcover legislation in your state—we’re here to help you!
3. Failure to discuss your workcover claim frankly and openly with your treating doctor(s).
A workcover claim should always be discussed with all your treating doctors, or at least with your GP. You and your doctor should decide how to handle frequent and repeated requests for, for example, information, IME’s and even surveillance.
Doctors are not always willing to support injured workers when faced with vexatious requests from an insurance company. Talk about it in advance, make sure your doctor is well aware of your claim. Ask your doctor(s) to notify you of all requests they receive from the workcover insurer.
4. Failure to stay in control of your workcover claim
Maintain a diary of everyone you speak to including names, dates and topic. Obtain a copy of all medical information yourself and submit to the workcover insurer with confirmation of receipt. Never fax without a printed confirmation of fax receipt. Ask questions, take names. Find out who is really making the claims decisions, get supervisor names, and/or ask to speak to supervisors (aka Team Leaders). Be polite, but stay in control of the claim. Enforce deadlines.
5. Failure to realise the workcover insurer is not ever acting in your best interests
Workcover insurance companies make money by NOT paying claims (i.e. benefits, medical treatment, weekly pay, home help, physio, counseling etc). This is the entire concept behind workers comp insurance “risk”. Never believe a workcover insurer is acting your best interests. Understand the intent and motivation of any workcover insurer (and case manager) and act accordingly.
[Dictated by Workcovervitim and manually transcribed on her behalf]