Another injured worker unjustly done over by workcover

screwed-over-by-workcover

“I feel that my story should be out there stating that I have been unjustly done by both the WorkCover Insurer and the Medical panel”, writes injured worker “R”. In essence “R” suffered a back injury and a hip injury, the latter discovered some months after the accident. The insurer accepted liability for both his back and hip injury, and even paid for “R”‘s first hip surgery. However the insurance company refused liability for further hip surgery, based on both an IME and a Medical Panel opinion who indicated his hip injury was not caused by his accident at work…Go figure!

Another injured worker unjustly done over by workcover

Work Cover Injury

By injured worker “R”

My original injury was for a lower back acceptance injury which happened back in [month] 2011 at my work place. After at a later stage of having surgery to my lower back in having a Lumbar Fusion I also noticed that I injured my right hip as well, which wasn’t recorded on the Workcover Accident/Injury form as the injury didn’t get picked up until late [month] 2011 to which my back surgeon found the right hip injury as well.

As all my doctors where telling me that it was all coming from my lower back injury that I had sustained.

I had surgery to my lower back but kept having right hip soreness. I went to see an Orthopaedic Surgeon which was for my right hip and did find that I had a Labral Tear in the right hip and therefore wrote to the Workcover Insurer to get this approved for surgery to fix my problem. I was then sent to see their so called Independent Medical Examiner (IME) which said that it would be recommended that I have surgery to the right hip to fix a labral tear I had.

Now the Work Cover Insurer accepted for me to have the surgery to the right hip, which I had. Unfortunately the surgery didn’t go well and went from bad to worse in having the surgery and I then opted to have it reviewed by another surgeon who recommended for me to have a Total Hip replacement which the WorkCover Insurer didn’t want to pay for it and sent me to get reviewed by yet the same IME doctor who recommended that the first surgery didn’t seem not at all appropriate to be paid for by the Workcover Insurer and then indicated that I didn’t need to have a total hip replacement and it’s only done to old age people and that the hip wasn’t hurt at my workplace accident I had.

Now this is the same IME Doctor that accepted the first hip surgery to be done, and they opted to pay for the first surgery to the right hip.

I went to a Conciliation Conference to have the decision overturned but to no avail and therefore got sent to a Medical Panel for an Opinion.

From there the Medical Panel agreed that the right hip was not injured at my workplace accident I had. I already had the surgery to the hip to have the replacement done before going to the Medical Panel as I had no option to have the surgery as I was losing strength and dragging my right leg and getting worse by the day.

With all this that was going on I had been confined to using a Four Wheeled Walking Frame due to my injuries I had to my lower back and now my right and left hips. With the weight that I had gained this had put extra strain to my shoulders as I was using my upper body to take the weight off my back and also my hips. With that I suffered to have a Rotator Cuff Shoulder injury to my left shoulder which also requires surgery to fix the problem I have with my left shoulder.

Now in saying all this I got two Medical Reports from my Surgeon that states that my injuries are a result of my Work related injury I suffered at work and therefore I required surgeries to my right hip and left shoulder. But the Medical Panel nor the Independent Medical Examiners didn’t agree and they made sure that these injuries wasn’t a result of my work related accident I had which is totally nonsense, as we all know that they are all working with the Workcover Insurance Companies and write what the Workcover Insurance companies want to hear.

I am wondering if there is anything that can be done to get this decision overturned by the so called Medical Panel as I feel that I have been hard dealt by the WorkCover Insurer Doctors (IME’s) and the Medical Panel.

Why did the WorkCover Insurer accept the first surgery to the right hip as I received an accepted letter by the Insurer to have the first surgery to the hip, which to me is saying that they are accepting the right hip as part of my work related injury and now not willing to accept the hip replacement surgery?

I assumed that if the WorkCover Insurer accepted the first surgery to have the labral tear fixed and now because I needed the hip replacement not willing to accept this now.

I already had the surgery as I needed it and my lawyer told me to go ahead and have the surgery as we were thinking that it was going to get accepted at the Medical Panel but it wasn’t to be.

I feel that my story should be out there stating that I have been unjustly done by both the WorkCover Insurer and the Medical panel; this is another yet another plain example that this system is unfair and it always favours the WorkCover Insurer and not the injured Worker.

I feel that I can go somewhere to get this dealt by and over turned by someone even though I went through the Medical Panel.

Kind Regards

“R”



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18 Responses to “Another injured worker unjustly done over by workcover”

  1. Just out of interest for NSW injured workers, I went to a forum held at Parliament House in Sydney this week. It was organised by David Shoebridge from the Greens who is vocal and active supporter of change to the draconian and blatantly inequitable amendments made to WorkCover legislation in 2012.
    The focus was on where to go to from here and what was endemically wrong with the current system.
    Four panels had been invited to speak including representatives from: scheme agents, WorkCover, Injured Workers’ Support Netwprk, WIRO , Law Society, Lawyers Alliance and various unions. Injured workers were invited to attend which is where I fitted in.
    It was disgraceful, and indicative of a certain attitude (disinterest?), that the two panels which did not attend were- WorkCover and relevant ministers and the scheme agent representatives. Apparently WorkCover had gagged the insurers from attending and speaking ( it has the the right to do so).
    The most heart- wrenching personal story I heard was from a woman I spoke to while waiting for the forum to begin. She was attending the forum to honour a close friend whose funeral was on that day. Her friend ended up trapped within the WorkCover system with terminal cancer. The trauma and anguish regular letters from the insurer caused, requesting proof she was unable to work, defies both humanity and commonsense. May she Rest in Peace and whoever was responsible for such inhumanity Rot in Hell!
    Much is rotten in the state of NSW!

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    • HI Selina, I have no doubt that the case manager got a bonus with the passing of this poor lady, wounder what i am worth to them at QBETFM they are all a pack of bastards

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      • We are nothing but a nuisance to the insurers and workcover. They have no intention of helping injured workers – that goes without saying, but they must love those nice, big bonuses they get when they get rid of us – pass us over to centrelink.

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        • Hi there, im another victim of the medical panel. I would like to reach out to all those who have been done wrong by the medical panel. As a group i believe we can do something to make this wrong right. Please send me your details about your case and email. Hopefully we can get enough of us to take it to the lawyers, media and government. Spread the word, Im marika.konstan@bigpond.com, love to hear your story.

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          marika

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      • Hi there, im another victim of the medical panel. I would like to reach out to all those who have been done wrong by the medical panel. As a group i believe we can do something to make this wrong right. Please send me your details about your case and email. Hopefully we can get enough of us to take it to the lawyers, media and government. Spread the word, Im marika.konstan@bigpond.com, love to hear your story.

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        marika

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    • Hi there, im another victim of the medical panel. I would like to reach out to all those who have been done wrong by the medical panel. As a group i believe we can do something to make this wrong right. Please send me your details about your case and email. Hopefully we can get enough of us to take it to the lawyers, media and government. Spread the word, Im marika.konstan@bigpond.com, love to hear your story.

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    • Hi there, im another victim of the medical panel. I would like to reach out to all those who have been done wrong by the medical panel. As a group i believe we can do something to make this wrong right. Please send me your details about your case and email. Hopefully we can get enough of us to take it to the lawyers, media and government. Spread the word, Im marika.konstan@bigpond.com, love to hear your story.

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      marika

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      • @ Marika- You may want to share a bit more about what happened first. You might get some good advice from people here.
        I very much doubt that anyone will send you all the details you ask for as it is a very unwise and risky thing to do.
        You are aware that WC stalk this site as well as PI’s etc
        Caution on openly sharing contact details with anyone.
        MadChef

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        • Thanks for the heads up. Thats why i didnt say too much and left my email. I dont know how to keep this any more private other than my email.
          About me…well i had a car accident was on WC for 10 ys to then be kicked out by medical panel and that nothing is wrong with me. Just tore my rotator cuff, carpal tunnel and CPRS. Insurance wont pay…say its due to previous injury…hmmm but nothing wrong with me medical panel said. Income protection wont cover me…previous injury they say. So now im left dead in water…need 2 operations and off fir 6mths. Im a chef single mum and im pissed. So a lawyer told me if i can get alot of us who have been done over by medical panel we may have a better chance as a group.
          Thats me….tired of being a victim.

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          • @ Marika- How come you ended up on WC when you had a car accident. Why weren’t you dealing with TAC?
            If it was a work related car accident what help did TAC give you?
            What state are you in?
            When you say you have CPRS are you meaning Complex (or chronic) Regional Pain Syndrome?
            Just asking in case I can help- not trying to do 20 questions.
            I have a friend who deals with TAC and is one of the good people.
            Post when you can

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            oneleggedskippy November 9, 2015 at 2:02 pm
            • Hi oneleggedskippy

              I was a contractor chef….so i was travelling to another job…which apparently means its WC.

              TAC and WC fought for the first year of my case. Never had any dealing with TAC. Im in VIC. Yes sorry i did a typo on the CRPS.
              No worries on the questions…all good.

              Went to the solicitors today…my case would be so straight forward if i was a sook and report straight away. Urrgghh if i knew at the time i tore my muscle i would have. So the moral of the story is, if you hurt urself….no matter how small it is. REPORT IT. Yeah right bosses love sooks. Urghh.

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              • @Marika- bunch of shits aren’t they. Not surprised TAC and WC were both trying to crawl away from their responsibilities.
                I too made the fatal mistake of not putting a wc form in straight away. As far as I was concerned I would just suck it up and then be back at work- well that was until the surgeries started…
                as for the CRPS.. what an absolute shit of a thing. I thought I was going completely mad until they told me what was going on.Sorry that you’re coping with that as well.
                Spend some time reading this site, it is extremely helpful.
                Have a look at your super fund (hopefully hostplus if in the industry) and see what TPD you have. Hopefully your lawyer has already done this for you.
                And you’re right if we reported every little bump, burn, scratch and cut I doubt there would be any chefs employed… we were taught to be tough

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                one-legged -skippy November 13, 2015 at 11:21 am
          • @Marika, Don’t know why a Solicitor would tell you that. Yes the system is corrupt but the Medical Panel is legally binding on all parties except as highlighted by WCV where an appeal would be warranted but that could only be done individually, not as a group. I think u have a case if the medical panel said that your previous medical issue had resolved (or did they say it was “no longer” work related)? These idiots can’t have it both ways, it’s either resolved and this is a new injury or just go down the path of this being an aggravation to a pre-existing condition/injury, which means it’s still work related and claimable (but you must have declared the old injury). Use their medical and legal reasoning to verify this is an old injury and if they then reject that Claim then you file a new Claim for a “new injury” and use their medical and legal reasoning back against them there as well. And around and around we go…… Also make a complaint to the Ombudsman if you have made all the other appropriate complaints as she is doing an investigation into them for denying Claims without valid reasoning etc

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            • Thanks for that advice Barb. Appreciate you taking the time.
              Sorry i have taken so long to reply….i havent been in a good head space of life and feeling pretty lost
              Thanks

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      • @Marika, get Admin to take down your personal details. If you want to communicate do it annonomously i.e. get a separate email in a fake name.

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  2. To ‘R’ – The decision of the Medical Panel in Vic can only be appealed on very narrow grounds. It is only possible to appeal the decision if the Panel has made legal error.

    It is not possible to appeal the decision of a Panel solely on the basis that it came to the wrong conclusion. However doctors from the Medical Panel(s) must provide detailed written reasons for their opinions/decisions. If the reasons provided for a medical panel’s conclusions are unclear it may be possible to appeal.

    In order to appeal a decision of a Medical Panel, it is necessary to demonstrate that they have made procedural error. This type of appeal is very technical and must be made to the Supreme Court within strict time limits. If an appeal to the Supreme Court is upheld, the decision of the Medical Panel will be quashed and the matter sent back to the Medical Panel for a further decision. It is normal for the new decision to be made by different personnel at the Medical Panel.

    Time limits

    Appeals against the decision of a Medical Panel are only possible on extremely limited grounds. An appeal against the decision of a Medical Panel must be made to a judge of the Supreme Court of Victoria.

    The time limits are extremely technical as an appeal can be launched either under the provisions of the Administrative Law Act or, alternatively, under the specific orders of the Supreme Court. Under the Administrative Law Act, the period can be as short as 28 days. (This period can be marginally extended more detailed reasons requested from the Panel and those reasons in fact supplied).

    Under the orders of the Supreme Court the normal period for appeal is 60 days from the date of the decision. The Supreme Court, however, has a general discretion to extend this period where it is in the interests of justice.

    I think the only way to know whether you have the option to appeal would be to seek sound legal advice from a very experienced personal injury lawyer.

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