Workcover insurers is about those who don’t think twice about convoluting and bastardising this system to meet their goals. It’s about unfeeling, uncaring corporate entities who care about only one thing; their financial bottom line. The following injured worker submitted story highlights, again, that the workcover (aka work-over!) epidemic is a national problem. Workcover insurers will simply stoop to the lowest of levels to try to beat an injured worker out of his/her lawfully mandated and guaranteed benefits…
Injured worker shares part of workcover journey and some valuable tips
I am just sharing part of my journey. I am robust but I can see how a physical injury can, through the machinations of the (workcover X) insurer, trigger psychological injury.
Part of my injury included a foot which, when it came to surgery liability was declined.
So, I spent 3 months collating all my evidence which I had kept including dates, documents, all correspondence and the insurer’s case file notes ( obtained through the Freedom of Information Act).
I had my union forward if for review on my behalf. It placed me under huge stress but I was determined to seek a just outcome.
Eventually the insurer ruled in my favour and accepted liability. I am still waiting for reimbursement of the monies I outlaid for the needed surgery.
I know that the only reason that the insurer ruled so is that their legal team could see that they would stand no chance if it went to the Workers’ Compensation Commission.
My case introduced no documents or evidence that the insurer hadn’t already received and evaluated .I have no respect or trust for the Scheme Agents who are supposed to service us.
I am also critical of a government (NSW) that passes such ludicrous legislation as the 12 month limitation on medical treatment.
Looking back over my claim almost half of that period was taken up by initial treatment and waiting for specialist appointments and then the reports that followed. The one IME I was sent to had a one month wait and took 5 weeks (should have been 10days) to submit his report. Approval for surgery took 3 months for the insurer to approve. Even the AMA has told the government that this time frame is totally unrealistic medically.
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