When Can You Claim Workers’ Compensation?

Each year, many Australians are injured or become sick due to their work. Many of these people are unaware of workers’ compensation and that they are eligible. They also may not know how they can make a claim or what their return to work obligations are. But don’t worry, the team at Anvil Legal are here to help!

What is Workers’ Compensation?

All employers in Western Australia are required to hold workers’ compensation insurance.

A worker can make a compensation claim if:

  • The worker is injured at work or has an injury caused or contributed to by workplace duties
  • The injury requires medical assistance and/or time off work

After making a claim, the employer forwards it to their insurer. The insurer then decides whether or not to accept the claim. If accepted, the insurer will start paying compensation to the injured worker. It will take some time to be processed so this should be done as soon as possible.

Weekly compensation payments should be made to the injured worker if the claim is accepted. These payments cover wages while they are not fully fit for pre-injury duties. The payments can also cover medical expenses and rehabilitation expenses.

What are the most common causes of Workers’ Compensation injuries?

Safe Work Australia’s latest Australian Workers’ Compensation Statistics outline that there were 130,195 serious claims made in Australia in 2020-21.

A serious claim is considered to be an accepted compensation claim for an incapacity that resulted in a total absence from work of one working week or more.

The main causes of serious claims (by the mechanism of injury or disease) were:

  1. Body stressing (37%)
  2. Slips, trips and falls (23%)
  3. Hit by moving objects (16%)

These three together accounted for three-quarters of all serious claims.

But there were many other types of mechanisms of injury and diseases. These include mental stress, vehicle collisions, heat and electricity.

What are the most common Workers’ Compensation injury types?

According to the Safe Work Australia report, injury and musculoskeletal disorders accounted for 89% of serious claims in 2020–21. Of these, the most common were traumatic joint/ligament injuries. This category accounted for 45% of all injury and musculoskeletal disorders claims.

Diseases were responsible for 13 per cent of serious claims. Mental health conditions accounted for 71% of disease claims.

How can I make a claim?

If you have been injured, immediately seek first aid and report the injury to your employer. After this, you must see a doctor and describe your injury to them in detail. Then obtain a First Certificate of Capacity and fill out a Workers’ Compensation Claim Form.

Make copies of both the Certificate and Claim Form for your records. This is so you can give the original documents to your employer.

Your employer has seven days to complete their part of the Workers’ Compensation Claim Form and lodge both documents with their insurer. They could receive a penalty if they fail to lodge the claim within seven days.

The insurer should notify you within 14 days after receiving your claim form whether the claim is accepted or disputed or they can provide a deferred decision notice. Give us a call if you have not been contacted by the insurer within 21 days of giving the claim to the employer.

If your claim is accepted, you should receive weekly compensation payments within 14 days. This is if your injury prevents you from working.

In the case your claim is disputed, no compensation will be paid and the insurer should advise you why. If you disagree with the insurer’s decision you should seek legal advice as it may require an application to WorkCover WA.

If the insurer may give you a deferred decision notice they are still required to make a decision (yes or no) on liability within 28 days from receiving the claim or face having to make provisional payments to you.

No one can dictate who you see for treatment purposes or attend treatment appointments with you; the new 2023 Act forbids it. Therefore it is recommended you see your own chosen GP through all of this.

What are my obligations when returning to work?

In some cases, your injury may keep you away from work for weeks, months or even years.

According to the Workers Compensation and Injury Management Act, if you return to work within 12 months of the injury date and the position is no longer available, your employer must provide you with a position that is comparable in status and pay, and that you are qualified and capable of performing.

If your employer wishes to terminate your employment during the 12-month period, they must give you and WorkCover WA 28 days written notice.

If your doctor certifies you with some capacity for work the employer must establish a Return to Work Program. This program sets out your restrictions in hours and duties. Your employer must work with you and your doctor to develop this program. The insurer may ‘appoint’ a return-to-work provider, however, you should look at finding one of your own choosing if you believe they are not looking after you.

The program must detail the actions that will be taken to enable you to return to work and who is responsible for those actions. It must also contain a signed statement that you agree to the program.

How can Anvil Legal Workers’ Compensation Lawyers help?

Anvil Legal has significant experience as a workers’ compensation lawyer in Perth. Our staff have personal experience of how a work injury can affect the lives of you and others.

Our goal is to make your worker’s comp claim go as smoothly as possible. We can provide you with supportive and professional legal advice in respect of any ongoing claim issues. These issues include weekly payments, medical costs and whether any settlement proposal from the insurer is the best option for you or not.

Give us a call on (08) 6143 5200 today to discuss your claim or visit our website and request an appointment. We offer a No Win No Fee Workers’ Compensation solution to approved clients.

References:

Australian Workers’ Compensation Statistics Report 2020-21, Safe Work Australia, 2022.