The more I think about how to describe what it is like to be a medium to severely injured worker on workcover, the closer I get to a description: it is war! It shouldn’t be a warfare -or better yet: an Asymmetric Warfare- but it is , this is what becomes because you will find yourself being attacked from all angles, even if you are certified seriously injured and are complying with everything they demand, and you will need to continuously fight for your rights and benefits, for your medical care and for any other -like service. This leaves many injured workers frustrated, mentally (and physically) exhausted, and totally disillusioned. I can’t help it but conclude that this warfare is done by design, as to make it as difficult as possible for injured workers in order to make them give up. Never ever give up!
Being on workcover is war
From my own experience of dealing with workcover and from the many stories I have heard and read through interactions with this site, I made a list of things that you should never expect and things that you should always expect when medium to severely injured and on workcover.
When on workcover never ever expect
Workcover, insurance agents, case managers and in many cases you employer will never show any respect for you, simply because by having suffered an injury in the workplace you become the enemy. You become a liability, both for the insurance agent and for the employer. In other words you cost money, you are out to “milk the system”, looking for a free holiday, a malingerer and a fraudster. You are guilty and are blamed for your injuries.
Have you ever noticed that if you keep your cool, not show emotions, and not abuse or use profanity in conversations or emails, they don’t know how to deal with this? Case managers are used to abusive injured folks (I know it’s very hard to keep your cool and wits as they will push your buttons) and they will classify those injured workers as emotional, nuts, or “difficult” and this gives them even more power and control over you. This phenomenon is also known as asymmetric warfare – that’s right: WAR!
Tip: Try to maintain control, be careful with the language you use in all communications – I am not saying this is easy as your adversaries (i.e. case manager) will push your buttons and trip you up…
Be careful with the use of language also in emails or letters. I believe emails are the best way of communication because you can make a draft, then reconsider what you are going to say, ask and modify and change it perhaps after a few hours or a night’s sleep. Always make a draft first and wait a while before you review it, so that you can edit it and ensue what you wrote/write is carefully put together.
What bloody integrity? Integrity is defined as a concept of honesty, consistency of actions, values, principles, methods and outcomes.In ethics, integrity is regarded as the honesty and truthfulness or accuracy of one’s actions. Integrity can be regarded as the opposite of hypocrisy. Injured workers’ adversaries (case manager, insurer, employer, so called “independent” doctors etc) will never make an effort in exercising integrity.
When you first get injured and at first point of contact “they” appear to be professional, at least on the surface. But this “professionalism” fades away the longer you remain injured and unable to return to work… and they will actually start treating you with contempt. Isn’t it interesting that although “professionals” (i.e case managers, even IMEs) are for example bound to strict codes of conduct, they will soon become unethical and immoral? And injured workers are supposed to trust these people?
Assistance, help or support
Fact, case managers (and any other adversaries) will do the very minimum of “work” possible – their priority is not to assist injured workers but to process endless paperwork, which is usually full of errors.
Tip: Please remember to read any and all “paperwork” you receive – just about every single letter I have received from workcover et al. contained errors. All documents are considered legal and can be used in a court of law!
Do not fall for their “games” i.e if they continue to harass you for paperwork, forms that need to be filled out or signed and returned by a certain deadline. Keep asking questions, don’t sign or agree to anything until you are absolutely certain that there are no breaches or violations of your rights (you would be surprised how many rights you could sign away).
Case managers are well known to say they will do something but then either not do it or do the opposite. How many times have you been told that the payment will sent weekly, but then it’s sent fortnightly. Question them and they’ll tell you it’s supposed to be weekly. How often have you been told that the cheque has been sent? Only to never arrive? How many times have you been told that “approval” has been given for a service or equipment, but then you never receive the actual approval letter? You will soon realise that it is not so much a game but mostly sheer incompetency.
Tip: when any adversary (i.e case manager) phones with questions or instructions, or if you phone them, always remember that those calls are recorded “for training and what not purposes”. Always, always ask them to email you with what was discussed or email them back after a call with what YOU understood what was discussed (and agreed to) and always, always ask for confirmation. I personally always take (well, took, for I have my case manager(s) on restraining order) notes and then email them back with confirmation of what was discussed.
From my personal experience I can honestly say that “they” all lied and lie to me. For example my RTW coordinator (employer) would tell me they would keep in contact, never happened. The case manager would tell me an MRI/whatever was approved but I never receive notification in writing. My employer would assure me that suitable duties would be organised for me and that I would have ongoing work, only to turn around and tell me that there are no suitable duties or unlawfully sack me because of “impairment”. How many times have you endured such examples?
Logic and or Intelligence
How often have you noticed that for example your case manager does not abide by common practice or even the workers compensation legislation? Have you ever had a logic conversation with your case manager? I certainly believe that case managers truly lack a certain level of intelligence required in their “field of expertise”.
When I was first injured, my rights were never ever explained to me, where they explained to you? Fact is that I had to go online to find out what my rights were, only to find out that my rights were breached over and over again. They either don’t care or are not properly trained (or both more likely) and will very seldom consider your injured rights – maybe they do this to keep “control”? Have you ever compared a reference to the workers compensation legislation stated on a letter you received from a case manager, with the actual legislation? You would be surprised how often the legislation is “loosely” interpreted and/or adapted to their need.
Duty of care
To be honest, my employer did not give a damn about me once I was injured. My case manager also did not give a damn about me and the fact that I kept re-injuring myself over and over again at work (“suitable duties”) because my employer didn’t give a damn about getting my medically prescribed and over and over requested ergonomic aides in the workplace. Whilst I had to undergo massive surgery just about every year, sometimes twice a year, to try to reconstruct my re-torn arm again, nobody gave a damn. The insurer never even questioned why I needed 7 massive reconstructions over a 5 year span “whilst at work in suitable duties”. No phone calls from the employer or insurer, no emails to see how was doing or progressing after each massive surgery, or to ensure that my rights were being observed or simply to see if I needed any support or assistance.
Concern for your wellbeing
As stated above and in addition, my employer for example cut off contact completely and so did my case manager, they simply had no idea and could not care less about my condition or how I was coping and whether I needed anything. Once thrown on the scrap heap (sacked as too impaired) and unable to return to any form of work for the foreseeable future, the real nightmare began, where my case manager for example would start to deny me basic medical care, cut off my physio therapy, attempt to cease my psychology therapy, deny or delay further urgent surgery, MRIs, home help, etc.
fact is that many, if not all workcover insurance companies and their case managers treat us like criminals and in fact by doing so are negligent to the point of putting our very lives at risk.
When on workcover always expect
Again, be very careful what you say during phone conversations – they are recorded and can be used against you. Also be extremely careful of “independent” medical examinations or insurers doctors/specialists as most are adversarial – their agenda is simply to prove in any way they possibly can that you are not as injured as you say you are and to discredit you.
Insurance carriers and their case managers in particular will often say one thing but then actually do another or the opposite. When you question them you will find that they (most often) do not really answer, but resort to their famous “mmmh”. If you ask a question an the answer is avoided, simply persist and force them to answer by using techniques like asking the question again and for example adding to it “is this correct yes or no?”; “I understand from what you are saying that blah blah, is this correct, did I understand it properly, yes or no?” etc. And as stated above always, always follow up all conversations with an email, to confim what was said or stated during the conversation (i.e. “I refer tom out telephone conversation – date-time – and understand that -blah blah – please confirm”)
This can be very draining, exhausting, frustrating, but unfortunately this is necessary and part of the warfare. Please persist.
Most injured workers that I know, including myself are continuously harassed and even intimidated by their adversaries. Be it the case manager or the employer or a rehab service provider.
Examples include being harassed to return to work, even though you are medically certified unfit for all and any work; being told that you should not need to see a psychologist “because you can talk to your case manager”; being harassed to follow another “therapy”, i.e. discontinue osteopathy and see a physio as it “works better”; rehab providers telling you that if you do not [do this or that] the insurance company will be “displeased”; rehab providers ringing you every day to “make sure you don’t forget to have your workcover certificate status/restrictions “changed”; and let’s not forget the harassment re independent medical examinations for “objective assessments” all the while sending you to a proctologist (bum doctor) when you have a head injury etc etc.
I certainly keep questioning my employer’s, my case manager’s and my previous rehab provider’s medical competence or medical qualifications, in continuously giving me “advice” to the “best treatment” of my complex injury.
It didn’t take me long to realise I was much better off not to communicate via telephone with all adversaries and stakeholders because just about everything I said would be twisted and misconstrued. Best way to communicate, as stated above, is by email – that way all is clear, transparent and you have logs to show that the email was sent (as opposed to “Oh I did not receive your letter… blah blah”).
Mistakes and “oversights”
As mentioned above, letters from insurance companies and your case manager are just about always erroneous – eve n basic stuff would be wrong such as the date of your injury, your actual injury (in my case I still suffer from a “bruised shoulder” – what a joke!). Try to have the letters corrected as all letters are legal documents which can be used in a court of law. Or follow up with email and refer to the mistakes and “oversights” in the letters you received.
Same apples to medical reports from “independent” doctors – have you ever received one that stated the truth and that was entirely correct? I keep being gobsmacked at the amount of “mistakes” such medico-legal reports contain! I remember on of them stated I was a “heavy drinker” – ha, me who does not even drink beer or wine ever! Another one stated my injury worsened because I fell on a beach (WTF!) whilst I had explained that shortly after I had had a reconstruction I was in a sling and walked on the beach and NEARLY lost my footing and my sling (with my arm in it) moved a bit forwards and I had quite a bit of pain from that movement… Another one stated I was on medication which I was not on etc etc. Rrright. Again it is very important to have medical reports corrected. Read them thoroughly, find the errors and fax or write to both the insurance company and the medical assessor and request an amended copy. They will often not even bother to reply to you, but at least you will have evidence that you sought an amendment/correction and that the information was wrong.
Breach of legislation
How often has your case manager, insurance company or even your employer breached the legislation? Rrright! Make sure you have a copy of the relevant workers compensation Act and that you study it as best you can. Refer to the Act over and over again and point out their breaches.
A good example perhaps is that insurance companies will go to great length to try and obtain ALL your medical information, all your medical history, including how many PAP smears you had. They are only allowed the information that is relevant to your injury, nothing more.
Another frequent example is breach of conciliation outcome certificates. Report it to the workcover authority.
How many times have you been treated with contempt and hostility? Take for example case managers not answeing your emails, not reimbursing you for medication accounts etc stating that they did not receive your receipts, even though you may have sent them via registered post a few times. How often has your case manager ignored requests for treatment, MRI, CT, physio, personal care, equipment? Rrright.
How often have you been told for example that they have “all the rights” to obtain ALL your medical history? Did they ever tell you that they would assist you with your rehab and return to work… did it happen? Did you also end up self-funding for retraining or training courses? Did you buy your own ergonomics for the workplace?
Have you ever received a torn or split envelope containing copies of your PRIVATE medical reports? They simply don’t care! Arrgg!
From my experience, they will just about always attempt to mislead you about just about anything. For example once I asked about my rights regarding physiotherapy and whether approval had been given, only to be told that the request for physio 2 x / week is “excessive”. Same with counselling. They deliberately mislead you into believing that certain treatments are restricted whilst the fact of the matter is that if your doctor/specialist prescribes daily physio or 3 x week counselling, then it should be approved. There are no limits, it’s about standard therapy for certain injuries and you are entitled to whatever your doctor says you need. Don’t be fooled.
Been ignored by your employer? Refused assistance with return to work? Refused assistance with your rehabilitation? Well, I can certainly say that I have been totally ignored on many many occasions by my (now former) employer since I was injured…
Never ever give up!
(Post pre-dictated and entered on behalf of WCV)