Workcover system dysfunctional – injured worker story

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After having visited our site, another brave injured worker decided to share his/her workcover story ordeal, again highlighting the reason(s) why our workers compensation system is extremely dysfunctional on multiple levels.

Workcover system dysfunctional – injured worker story

Workcover Diary of injured worker ‘A’

“The date of injury is actually the date of an aggravation of the original complaint. The date of aggravation is (day, month) 2013.

Seven days after the claim was made I received a telephone call from Gallagher Bassett (NSW), the reason my claim was sent to the New South Wales office was because my employer is based in NSW and they sent it there. The claims manager who phoned me made a determination to accept the claim.

Within a few days I received letters from the NSW & SA offices of Gallagher Bassett (GB) explaining the mistake and informing me that (case manager) “G” from GB Adelaide would be my new claims manager.

Approximately 10 days later I rang G as I had not been contacted by him. The information from him was that I had not completed a Workcover claim form, so he could not do anything about my claim. I contacted GB NSW and was told they had sent all the information to the SA office including the claim form. I spoke to G  again and was told there was no claim form and he said I could go online and complete a form.

I went to the GB website and filled out the SA Claim Form (still available), there was still no response from G and when I spoke to him he told me that the online claim form is not a claim form. I was angry after this and contacted the Workcover complaints department who told me that there were real issues with the way my claim has been handled, by this time I had been without pay for a month.

Workcover contacted me and told me that I needed to supply a new claim form and my bank details and that GB case-manager-fun2would make a “special” payment so I would receive what I was owed by the Friday of that week, G confirmed this. I did not receive my pay and was told by another manager that they only made payments on Tuesdays.

I ceased working on (day, month) 2013 and received my first pay on 9day, month) 2013. (more than a month later)

On (day, month) 2013 – about a month later- my payments ceased because they had determined that I did not have a claim, that’s when the fun started and I put in an appeal to the Workcover Tribunal.

This process took 10 months and on (day, month) 2014 GB’s rep said that the claim would be accepted. GB held up the signing of the orders by saying they did not know what my average weekly earnings were (well what were they paying me at the beginning?) they were eventually signed on (day, month) 2014 (about three weeks later). It is now the end of (another month) 2014 and I still have not received any back pay.

After many complaints to Workcover and GB and eventually to the Attorney General’s office I have been told to expect it next week (I was told that before).

During the appeals process I was examined by specialists and it was discovered that I have a secondary condition linked to the first and on 9day,month) 2013 a second claim was sent to GB. When my appeal was successful I wrote to GB asking if the new claim had also been accepted, with no reply.

After more complaints to Workcover I was told that the claim was filed and nothing had been done with it. I now have to see the same Doctor who reported that the original claim was not work related, I can see myself back at the appeals tribunal very soon.

I was advised recently (month 2014) that I have to have a work capacity assessment to see if I can go back to work, the problem is that I have not had any treatment yet and for the past 16 months I have been sitting at home in constant pain, doing nothing, and now they want me back at work! I suppose if they can’t get me off the system one way…

During this whole process, not having any real control of my life, being in constant pain and financial hardship, my mental health has severely suffered.

Yes I have had depression for many years but I have dealt with it. I am not dealing with it anymore, I have changed considerably and my family has noticed the changes. (the previous section was written (day/month) (recently). ”

Image, courtesy of injured worker “it’s just wrong” – with thanks 🙂

 



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14 Responses to “Workcover system dysfunctional – injured worker story”

  1. I just read your story and wanted to say I sympathise with you for the sole reason of having to join through no choice of you own the rest of us that are introduced to a whole new world (hell) that consists of greedy,heartless,demeaningful,bullying type of behavior that is regarded as the norm,as I myself have now been dealing (fighting ) with the Vic workcover syst for aprox 9 years now as my husband was injured at work in 2005 and then after being put on light work duties for a short period of time (that he believes,were put in place to demoralise him so as he would leave and find other work therefore voiding them of any long term commitment (liability) to him financially,but it didn’t work as he knew he was unable medically to do just that ) then after the period he was put off due to down turn in work ,(yet they employed other empoyees from a local work agency with in only a24hr period to cover the work load wt??) we then spent the first 12 months proving that he indeed had suffers from a work injury and not a predetermined hereditary condition even thoe my husband had always been a heathy hard worker that had never made any type of work injury claim of any type and had worked as a labour of some type in a lot of dangerous environments since leaving school,again wtf?!?! Anyway of I was to tell you the whole story it would take all day of typing and most prob leave me in tears once again with the thought of what we’ve been thru as afamily caught up in all this 🙁 so to make our very long journey thru hell short ,after now 9years of myself and my husband fighting for his wages that were court ordered,yet still continued to get cut off regularly (the favorite I have began to learn is for a few week befor Xmas and not be able to rectify the matter till after the Xmas holiday period leaving you with no money for the family for Xmas day:( it’s heart beaking I can tell you) for one stupid reasons or another on behalf of one of the most heartless breed of creatures that I have ever come across it seems they have to fit the sociopath profile to work as a workcover caseworker !!! They are a (apart from Sadly to say the lawyers that I have had the mispleasure to deal with the ones who should be helping the injured workers and There FAMILIES!!instead of just taking what ever money they do manage to get) bred of their own . We fought them all the way through the conciliation,mediation,medical assessments and medical panels with proof from all of my husbands injuries yet now as we got to last couple of months the law has left us with no other reasonable option but to settle out of court and to let the workplace and employers get away with there obvious lack of safety procedures for future workers and 9 years of our lives put on hold basically for nothing , then I read in the local newspaper ( only not even a week after the papers were signed off and we were brushed under the carpet) that a man was killed doing his job at that very same work place,and they stated they had a perfect safety record at the workplace so they didn’t know how this could of happend WTF!!!! Yet my husband now is never able to return to work again along with to many other people that have sustained injuries at the worksite over many years!! At work safe and the departments that could be doing things to change this sort of things from happening on such a reg basis chose not to do anything ,.i thought that when all this started, that as a security officer that deals with the law regularly ,that laws that were in place to make life fair,safe for all of us that do the right things,yet I have found since dealing with workcover laws that the most helpful thing I’ve ever been informed about the law and that was by a very expensive senior solicitor and that was”never try and make sence of the law,because you would succeed as it doesn’t make sence to begin with!! Go figure hey ,

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    • Robyn the sooner you put this very regrettable saga behind, and make the best of your family life the better it is. Eventually they will all be held accountable. I wonder if they have an ounce of humanity in them.
      Francis

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  2. I know the feeling QBE are treating me like a criminal and workcover strips you of all your human rights and tomorrow I am facing the medical panel and hope those doctors do the right thing. I have been denied medical treatment due to an assault by a disabled client and made me loose my faith in humanity, lets hope this panel is not in the pockets of QBE and do the right thing and give me back my life and acknowledge my ligitament claim. I need medical treatment and depression has put me in a dark place, QBE wastes money on so called professionals waste money what about there injured workers and as a disability carer I have been tried to be bribed by offering me a couple of thousand dollars by QBE and told take it and go away how pathetic are these insurance companies and pathetic excuses I call them inhuman yet they are quite happy to sponsor Sydney Swans and discriminate me and put me through hell and I suffer with pain and depression due to my assault. I have even thought of doing myself in but thanks to my GP, Psychiatrist and help from family and friends I am just hanging in there and feel blessed with there support Beyond Blue and life line etc had help and I did nothing wrong I am the Victim and God help me, Let the Medical Panel do the right thing and abide by the Medical Oath they took and fact remains I am the Victim. Lets see what happens tomorrow,

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    Irene Perfetto August 6, 2014 at 4:13 pm
    • Yes we too had to deal with QBE along with CGU and their totally discracful ways of tryin to deprive the injured worker of needed medical treatment and weekly payments but. instead add to there injury by mentally antagonising them until they are at wits end ,and suposibly just to save them money yet they then pay thousands on survalence and the likes to try and disprove the injury and belittle the worker like they have my husband and sadly by the sounds of what you have said you also,it make me sad to read your story because I know personly how horrible these mongrels are and how had they make life for you just because they can 🙁 but from experience dealing with the medical panel (which we had to attend on three seperate occassions due to rewording of questions put to the panels from QBE )has been the one fair process with real drs assessing the injurys throughout the whole ordeal so I hope all goes well for you tomorrow and that you are fortunate enough to get the answers from them that you need along with the medical treatment that it sounds like you desperately need,as for letting them get to you don’t let them get you down I know it’s hard when they put so much effort into draining you ,:( but don’t let them beat you because the one thing we have that they can’t take away is our will to fight and eventually someone must listen and do something to change this system that is so broken that it needs a complete over haul to ever function corectly,,take care and as I said before Good Luck tomorrow,I know that I don’t know you personly but my heart and thoughts are with you,:)

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    • Irene they are probably trying to make an injury claim so hard that no one would make a claim. The contradiction is that the scheme is designed for the injured and bullied victims and not for them. This is a rather long road, and only the strong can make a difference. A medical panel decision is good because the result cannot be contested. Well we will have to wait and see.
      Francis

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  3. And it just doesn’t end….
    I had a radio frequency requested in January this year, It took some 4 months or so to eventually be told it was denied.
    I had a call from workcover assist, because yes I have sent the matter to conciliation, and guess what… CGU didn’t send all the treating Drs info through to the IME they sent me to. They have now furnished him with the balance of info and are expecting a further report end of this week. Regardless of that, if they read the WHOLE report, he did say the radio frequency was reasonable, and that there was probably no procedure that would give me permanent relief. Apparently there are apologies, but that just isn’t good enough. I have lost the majority of my work because I am unable to function fully with the pain.
    On top of this, I have submitted a claim for Income Protection through my super…. its now taken the initial 2 month no work period (because I was initially told I had to wait before lodging the claim) plus over 3 months and still no answer.
    Is it any wonder so many people get depressed and/or really angry.

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    • Well surprise surprise… the radio frequency treatment will now be funded… I guess better late than never, but I am sooo angry at CGU…. Thanks to Workcover Assist and my Dr’s and legal team for their efforts…
      This may have saved them(CGU) money in the short term, but its had a huge cost to me and my kids.

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  4. Thanks Francis for your advice,and that was what I had intended to do,to try and put all the horrible treatment we have endured,many years of mental anguish all at the hands of QBE VWAand all others that have connection to the case that have contributed along the way,but now it seems that they have decided to have their last laugh at us by no leaving us without any means of income as they cut my husbands court ordered weekly wage on the day of mediation 15th July even though we were not notified that this would happend by our so called solicitor instead he informed us we would have access to funds to pay mortgage payments and live day to day untill the measly amount settled on was paidinto our account but instead we are still sitting with money to live on till god know when ..it’s just not fair I’m sick of being left in tears in completely hopeless circumstances trying to raise our four children and help my husband to get along daily with his depression and injurys caused and contributed to by these monsters and yet I can do nothing but pour out ny misery and anger on here as I’ve tried so hard for so many years to get them to listen but even after I thought it was all over I’ve found it was all a complete waste of time ,thank u so much workcover diary for being here for us to have our out pours becaus as such a strong minded person who let’s nothing get the better of me on a daily basis all my life from loseing my brother to murder that yet has never been solved and many Other terrible situations over my 37 years of life so far ,but I must say I have never felt so alone as I do at t the moment thanks to the people in the prementioned places (QBE,Ect) and their morbid ways of trying to and succeeding in makeing injured workers and THEIR FAMILIES,lives hell :((,,,,

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    • What ever I say would be like a band aid, having read what you and the family have been through. I am just a single person and can battle on. I often wonder if this should happen to a family of two with a mortgage. It is a huge concern. The least Worksafe Vic., and its many agents could do is treat the injured and bullied victims with a bit of courtesy and respect, with a duty of care. If they can not get that right it is best that this monstrosity be excluded from the civilized world. Every generation is an improvement on the previous one, as is evident with the new technologies. it is just a matter of time.
      Francis

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  5. If the claims agents were paid a fixed amount instead of claiming payments for providing individual services that they force upon injured workers in order to produce invoices, there wold be less harassment and less costs.

    If all workers where not treated like criminals because of the few rorters, there would be less mental problems and further additional claims.

    If the practice by claims agents of ‘doctor shopping’ to find one that suits an agenda of mistrust rather than accept the IME opinion of the claims agents doctor, there would be no need for genuine workers and lawyers arranging another IME with another doctor.

    In short more money is spent disputing a claim than just accepting it. In my case I went through the gauntlet of doctors and lawyers and Tribunals although no dispute as to how my injury was caused (negligent employer) or the severity of the injury was ever made by any party. I was still sent to one doctor after another. All of whom determined my injuries and claim to be true and genuine, yet I was sent to the Medical Panels.
    The outcome of that was the same as all the other medical reports, the difference being the claims agents could not interpret the report to suit themselves. It was final and binding on all parties. It determined I was working to my maximum capacity of 25 hours a week and doing alternative ‘suitable’ work with another employer. The Medical Panels got the leeches off my back, until now. Four years after the Medical Panel examination I am now once again having to attend an IME although none of my circumstances have changed.
    When I asked GB what part of ‘final’ don’t you understand? Their response was that the Medical Panel stated “I was most likely to be” rather than “I am most definitely to be” permanently incapacitated!! Those terms were not in the statutory questions asked of the Medical Panel so how can the claims agent act on them?
    The whole system is a joke and because politicians and claims agents sitting at desks who don’t do anything physical to risk an injury, never experience the fiasco they are the makers of. After 7 years of being on the system and not one questionable report to give suspicion that I am rorting the system, I am once again being treated as a crook. If genuine workers are injured they should just be treated as such and the insurance paid. More money is wasted ‘fishing’ than just complying with the Act as it was intended.

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  6. Yes Frank I just read your post and I agree totally with what you wrote ,the part that amazes me is there are so many of us in the same type of circumstances yet still nothing has been done to rectify the problem..hopefully if we make enough noise we can’t be ignored forever,,you would hope anyway , 🙂

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  7. Hi
    I feel for you and know exactly what you are going through I have been going through it now for 4 years I thought by now there would be some light at the end of the tunnel but now so I hope it does not take that long with you. As you said you become a different person and its your family that suffers the most.
    Good luck

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  8. Many ironic years ago I worked for a medico-legal group of Dr’s, what we refer to as IME’s. Believe me there sole income is around supporting where their income originates, they are not going to bite the hand that feeds them.
    We have to stay truthful & honest & use every single loop hole & every piece of fiction they drum up to deny claims against them.
    It is no help when you are in the thick of it yourself, yet don’t let the bastards get to you. That is their intention. They want you to be so stressed & so frustrated you give up. It saves them more denial & more IME’s & more time.
    I sat in on the Parliamentary inquiry into the NSW Workcover system & I listened to Treasury & our politicians refer to Workcover (NSW) claimants as having “a sense of entitlement”.
    What is there not to believe about our policies & legislation that says it will cover our backsides if we are injured at work? Are they suggesting we shouldn’t have any belief in those policies, that the legislation is no more use than to wipe their backsides (or maybe the paper is too rough/cheap/nasty?)
    It makes me sick to see what human beings do to other human beings who are vulnerable & that is what happens when you are no longer at your full capacity, when you are a vulnerable version of yourself. They affect every aspect of your life & hurt your relationships, your family, your sense of dignity & take everything that mattered, your career, your goals etc. Yet we cannot let them take our future.
    I am just about out of this system and only now fighting with the Superannuation company & the laughable IME reports they call expert advice. You just want to send them back & say try again, are they serious that we actually really believe that the IME has anything decent to say other than support what the Insurer wants to hear?
    When are these fraudulent, cruel and immoral practices going to become so widely known we can out them all for what they truly are, the scum we wipe on the bottom of our shoes?

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    • Hi Maggie ,
      I havnt had internet available since my last post several months ago, and I havnt had a chance to read your comment till now,I’d just like to say thank you as it brought an instant smile to my face to know that there are people like you that agree and understand that these horrible practises do happen and it’s not just a self pity issue that’s only in our heads it is reality as you’ve worked within these monsters guid lines and know just how in humane that they have become, thanks once again take care 🙂

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