Workers’ compensation (aka workcover) was created for two primary purposes—to provide at least partial compensation for lost income and to pay for medical treatment and rehabilitation services for workers injured or made ill on the job. This approach seems to offer a good deal—if it only worked.
Tony Abbott’s “biggest bonfire of regulation in our country’s history” will allow some organisations to opt out of state compensation schemes and instead operate under the Commonwealth’s scheme, Comcare.
According to The Conversation, This change is likely to be counterproductive in an already messy system and has the potential to further undermine the viability and fairness of workers’ compensation arrangements in Australia.
Any workcover issue can lead to disputes and/or litigation, and many do. If you have a particularly aggressive workcover insurer that loves nothing else but deny cases, benefits and settlements, it will often lead to legal hearings over adversarial decisions the workcover case manager made on the claim. Some workcover claims/cases which are in litigation are more complex than others, but all have one thing in common: they (generally) drag on forever. Let’s look at some of the factors involved that (may) lead to protracted litigation/settlement.
Imagine being a hard-working Australian with a family of three or four and a job that perhaps just barely supports them. Now, imagine you are injured at work in an accident or incident and through no fault of your own, or through the sheer negligence of your employer. You are suddenly forced to survive without any income while your employer’s workcover insurance carrier attempts to determine if you were really, really “injured at work.” Hey, it could well be that you suffered from ‘old age’ degeneration, or worse, the insurer may try and blame your injury on a ‘pre-existing’ condition, after all you may have fallen off your rocking horse when you were 5 years old.
“It’s under investigation” Delay, delay. “We are waiting on some records.” More delay. “It takes a while to process your information in our system.” “We’ll let you know when we make a decision.” “I’m sorry you haven’t gotten your weekly pay, I’ll look in to it.” More delay…. Does any of this sound familiar to you?
Yesterday we were pretty fortunate (so we think) to have been contacted by a former occupational therapist, now turned defense lawyer for workcover (aka the opposite side). We believe this lawyer does share some valuable tips with regards to litigating workcover claims, and how best to proceed in order to obtain your rightful benefits and compensation, such as the need to be firm and back up your claims in a strong manner, and to be honest /realistic about how much you think your injury is worth.
Further to the horrendous story highlighting the importance of knowing your rights when it comes to all things workcover. That you need to stand up for yourself, learn to say “no”, not be intimidated, pressurized, bullied or threatened when it comes to lodging a workcover claim, being forced to return to work prematurely or in the most unsuitable duties, whether by your boss, case manager, rehabber or even doctor; and further to the sad but true fact that many injured workers are reluctant to file a workcover claim, because they feel that they would be seen as suing their bosses, and others are afraid of reprisals; the following article explains what you can do if your employer encourages you not to lodge a WorkCover claim.
How often have we heard about injured workers who are reluctant to file a workcover claim? Most feel that they would be seen as suing their bosses, others are afraid of reprisals.
A recently released report by SafeWork Australia shows that there has been no improvement in our national return-to-work rates for the past 15 years.
The workcover system was basically designed to be non-adversarial and for the defendants (that is: the workcover insurer) to properly and honestly pay compensable workcover claims without forcing the injured worker to jump through needless hoops, such as being doctor-shopped (being sent repeatedly and unreasonably to countless independent medical exams; or file for hearings (i.e. conciliation, arbitration etc) when legitimate benefits are delayed or denied.