Lodging a Workers Compensation Claim in Victoria

WorkCover is a type of insurance that covers workers who are injured physically and/or psychologically, while performing their duties. Injured workers can claim compensation regardless of who is at fault for their injury. For example, if you accidentally trip over your own feet and fall at work, you may still be entitled to compensation.

If you sustain a new injury and/or illness, or even an aggravation or acceleration of a pre-existing injury or condition in the course of your employment, you are likely to be entitled to workers compensation. Whilst the claim is made against your employer, it is more likely to be managed by your employer’s insurer.

All Victorian workers, who are employed on a full- time, part- time and casual basis, are entitled to compensation under the WorkCover scheme.

Why do I need to lodge a Workers Compensation claim?

A workplace injury and/or illness can affect you physically, emotionally and financially. It can often be a stressful experience, for yourself and also your family. Workers compensation is aimed to support injured workers and assist them in returning back to the workforce.

It is imperative to lodge a Workers compensation claim if you are injured at work, as you may be eligible to a range of benefits that include the following:

• Medical and treatment expenses in relation to your accepted work related injury and/or condition
• Home help services
• Travel expenses to and from your treating doctors appointment
• Weekly payments if you are unable to return to work or unable to work your pre-injury hours
• Lump sump compensation for a permanent impairment
• Return to work services

I had an accident and I don’t know what to do – Is there a formal process? Where do I start?

The thought of lodging a claim may seem daunting, however it is important to lodge a WorkCover claim, in order to access the benefits under the scheme. Simply follow these steps:

1. Report the injury to your employer – it is imperative to report the incident to your employer, no matter how minor the incident is. This is to be done in writing within 30 days of becoming aware of your injury.
2. Consult your doctor – See your doctor to assess your injury and seek appropriate treatment. Remember to advise your doctor on how you sustained your injury. If you are unable to return to work,  obtain a certificate of capacity from your doctor. [NOTE: You must obtain a certificate of capacity if you are making a claim for weekly payments. A medical certificate will not be enough to be paid under WorkCover]
3. Lodge a WorkCover claim form – If you need to take any days off and/or require ongoing medical treatment due to your work-related injury and/or condition, you must complete and lodge a WorkCover claim together with a certificate of capacity as soon as possible.

You can get a Workcover form from any of the below:

• Post Office
• Your doctor
• WorkSafe website

What do I expect after lodging the claim? What if I can’t return to my pre-injury duties?

Once you lodge the WorkCover claim form with your employer, your employer has 10 days to forward the claim form to their WorkCover Insurer. The WorkCover Insurer then has a further 28 days to review the claim and either accept or reject the claim. The WorkCover Insurer may appoint an investigator to obtain a written statement from you or schedule an appointment for you to see an Independent Medico legal Examiner, prior to making a decision about your claim.

If your claim is accepted and you are unable to perform your pre-injury duties, you should continue to obtain a Certificates of Capacity and provide it to your employer and WorkCover insurer. If you have incurred any out of pocket expenses in relation to the accepted injury, forward a copy of the invoice or receipt to your employer or WorkCover Insurer for reimbursement.

If you have not received a response from the Insurer or you disagree with any decision in relation to your claim, we suggest that you contact our team, as you have 60 days to dispute the Insurer’s decision.

What happens to my job? 

Your employer cannot terminate your employment or threaten you for lodging a WorkCover claim. It is important to note that upon lodgment of your WorkCover claim, your employer is legally obligated to offer you suitable employment for 12 months from your date of injury. If you are unable to return to your pre injury duties after 12 months from your date of injury, your employer can legally terminate your employment. However, the termination should not affect your WorkCover entitlements.

Contact Us
If you or someone you know has been injured in a workplace accident contact Zaparas Lawyers today for an obligation free assessment of your claim.

*This piece was written by Biyanka Dsouza, Lawyer in the Zaparas Lawyers WorkCover team.