What can I claim through WorkCover compensation?
Written by John Cramp, Senior Lawyer
A workplace injury can occur at any time, and it can have a significant impact on your health, finances and future. Whether you have suffered a physical injury on a construction site, developed a repetitive strain injury in an office, or experienced a work-related psychological illness, you may be entitled to a range of benefits through Victoria's WorkCover scheme.
Understanding what you are eligible to claim through WorkCover is essential to ensuring you receive the support and financial assistance you're entitled to. In many cases, injured workers are surprised to discover that WorkCover can sometimes help with much more than just lost wages.
If you have been injured at work, the experienced personal injury team at Maddens Lawyers, led by Kathryn, John and Jess, can help you understand what you are eligible to claim. Contact our team today for an obligation-free consultation about your claim.
Read more about WorkCover injuries below:
Who can make a WorkCover claim?
In Victoria, workers who have suffered an injury arising out of or during their employment may be entitled to compensation through WorkCover. This can include full-time, part-time and casual employees, and in some cases, can also include contractors and self-employed workers. Common workplace injuries include:
- Back and neck injuries
- Shoulder and knee injuries
- Repetitive strain injuries
- Hearing loss
- Occupational illnesses such as asbestosis
Aggravation of pre-existing conditions may also be covered. If you are unsure whether your injury qualifies, speak to our personal injury team today to help protect your rights and avoid costly mistakes.
Weekly compensation payments
One of the most common forms of WorkCover compensation is weekly payments to replace lost income when you’re unable to work or your work capacity has been reduced.
These payments are generally calculated based on your ‘pre-injury average weekly payments’ (PIAWE), which reflects the income earned during the 12 months before your injury. These are calculated and paid as below:
- Week 1 to 13: Paid at 95% of your PIAWE, including any overtime and shift allowances.
- Weeks 14 to 52: Paid at 80% of your PIAWE, including any overtime or shift allowances.
- Weeks 53 to 130: Paid at 80% of your PIAWE, excluding any overtime or shift allowances.
In some circumstances, weekly compensation payments can continue beyond 130 weeks if you have no current work capacity that is likely to continue and a whole person impairment of 21% or more.
Another important benefit that many workers overlook is superannuation. If you have received WorkCover weekly payments for more than 52 weeks, the WorkCover insurer may be required to make superannuation contributions on your behalf.
Need help with weekly payments? Speak to the team at Maddens Lawyers for practical advice tailored to your situation.
Medical and related expenses
WorkCover is designed to support your recovery, which means it may cover a wide range of medical and rehabilitation costs linked to your workplace injury.
Common medical and like expenses include:
- GP appointments
- Specialist appointments
- Hospital treatment
- Surgery
- Physiotherapy
- Occupational therapy
- Psychology and counselling services
- Prescription medications
- Diagnostic testing
Depending on your circumstances, additional assistance may also be available including home help services, home modifications and mobility aids.
The key requirement is that the treatment or service must be reasonable, necessary and directly related to your workplace injury. The final determination will be made by the WorkCover insurer. If you are unsure if your expense is covered, speak with our personal injury compensation team today.
Impairment benefit claims
If your WorkCover injury results in a permanent impairment, you may be entitled to an impairment benefit claim, which is a lump sum payment separate from the weekly benefits.
Before you can make an impairment benefit claim, your injury must be stable at the time of assessment, which generally means a waiting period of approximately 12 months from the date of injury or surgery before the assessment can be undertaken.
The minimum impairment thresholds vary depending on the type of injury.
- Musculoskeletal injuries: Injuries involving the back, neck, shoulders, knees and ankles, generally require a minimum whole person impairment assessment of 5%.
- Other physical injuries: Injuries such as hernias, hearing loss, heart attacks and strokes, generally require a minimum whole person impairment assessment of 10%.
- Psychological injuries: Require a minimum whole person impairment assessment of 30%.
The WorkCover insurer will arrange a medico-legal impairment assessment to determine your whole person impairment. The amount of compensation is determined by the whole person impairment percentage and is indexed annually.
Importantly, an impairment assessment is not always final. If there are concerns regarding the assessment outcome, the impairment rating can be challenged by referring the assessment to the Medical Panels.
Because permanent impairment claims can substantially affect your entitlements, professional legal advice is strongly recommended before attending an assessment.
Serious injury and common law claims
For workers who have suffered significant injuries due to negligence, a common law claim may provide access to compensation beyond the standard WorkCover benefits.
Common law claims can be brought against an employer whose negligence caused or contributed to your injury or illness. To succeed, you must show substantial evidence that your injury arose due to the negligence of your employer. This involves proving a breach of duty of care owed to you, such as failure to address a reasonably foreseeable risk of harm in the workplace, a breach of manual handling regulations, or another failure.
Serious injury application
To initiate a common law claim, you must first submit a Serious Injury Application. You must be assessed as having suffered one of the following:
- 30% whole person impairment.
- Permanent serious impairment or loss of a bodily function.
- Permanent severe mental or severe behavioural disturbance or disorder.
The application process is highly technical and requires detailed medical and legal evidence. This is where experienced legal representation from the Maddens Lawyers personal injury team can make a significant difference.
Common law claims
A successful common law claim may seek compensation for pain and suffering alone, or for both pain and suffering and economic loss.
- Pain and suffering compensation relates to the impact of the injury on your lifestyle. There is a threshold to determine if the consequences are ‘serious’ when compared with other claims.
- Economic loss damages can only be claimed where any residual work capacity prevents you from earning more than 60% of your pre-injury income. Your previous three years of tax returns will be used to assess your prior earning capacity.
Once the Serious Injury Application is lodged with WorkCover, the employer’s or defendant’s lawyers have 120 days to accept or reject the application. If rejected, proceedings may be commenced in the County Court of Victoria for the Court to determine the application.
Give the potentially substantial compensation involved, common law claims should always be managed by experienced personal injury lawyers.
Speak to Maddens Lawyers about your WorkCover claim today
Navigating the Victorian WorkCover system can be complicated, especially when you’re focused on recovery. Whether you’re seeking weekly payments, medical expenses, an impairment benefit or pursuing a serious injury claim, obtaining the right advice can make all the difference.
At Maddens Lawyers, our experienced personal injury team has helped injured Victorian workers pursue the compensation they’re entitled to. We understand the challenges workplace injuries create and are committed to guiding clients through every stage of the claims process.
Contact Maddens Lawyers today for an obligation-free consultation and find out how our experienced personal injury team can assist with your WorkCover claim.
