WorkCover Queensland is a government owned statutory body, providing workers’ compensation insurance to Queensland employers since 1997.
It is mandatory for all Queensland employers to hold a workers’ compensation accident insurance policy.
If you are a Queensland employee, you are covered by your employers’ workers’ compensation insurance policy.
If you are a Queensland employee and you are injured at work, you may be eligible to pursue a statutory claim and/or a common law claim.
WorkCover provides a ‘no fault’ scheme where you will be entitled to receive statutory compensation if you are considered a worker and you sustain an injury that arises out of, or in the course of, your employment and:
Compensation will not be paid if your injury was intentionally self-inflicted or, caused by your own serious and wilful misconduct.
To be covered, you must have suffered the injury or disease in Queensland, or if it happens elsewhere, your main place of employment must be in Queensland.
(a) Definition of a Worker
A worker is an individual who works under a contract for service and is an employee for the purpose of assessment of pay-as-you-go tax (PAYG tax) withholding. This can include sub-contractors, but it is usually the standard employer/employee relationship where wages are paid in return for labour.
There are some groups of people who are excluded from receiving workers’ compensation entitlements including professional sportspeople, and a member of a crew of a fishing ship in certain circumstances.
WorkCover is entitled to enter into contracts of insurance to cover some volunteers working in emergency services, local government, statutory bodies, unions and charitable or other non-profit organisations.
(b) What injuries are covered?
All work-related personal injuries are covered by workers’ compensation insurance including physical, psychiatric, psychological disorders or an aggravation or such conditions.
Injury also includes diseases, aggravation of diseases, hearing loss and death.
(c) Injured during employment
Usually incident’s resulting in injury occur in the workplace, but there are several other circumstances that are covered by workers’ compensation insurance. For example, while the worker is:
(d) How to make a WorkCover Statutory claim
You can lodge a claim for compensation by completing a WorkCover claim form and a WorkCover medical certificate.
The medical certificate must be obtained from a medical practitioner or, for a minor injury, a nurse practitioner. The certificate must be lodged with the claim form. The documents can be lodged with WorkCover in a variety of ways including by post, in person, by telephone, fax or over the internet. The claim form must be truthfully completed.
A copy of the claim form should be served on your employer. You should also keep a copy of the documents and make a note the date your claim was lodged.
WorkCover has 20 business days after receipt of the claim form in which to decide whether to accept the application for compensation. WorkCover has the right to ask the worker to provide a statement and any other proof of the injury and its cause. The worker may also be asked to attend a medical appointment with a WorkCover doctor and must cooperate with such a request.
(e) When will your WorkCover Statutory Claim come to an end?
If your statutory claim is accepted it will not remain open indefinitely. It will be finalised by WorkCover upon your injuries being classified as stable and stationary essentially, that your injuries will not improve, and that no further medical options are available. Unfortunately, WorkCover will rely on the opinion of their medical examiners in this regard even if these opinions conflict with the opinions of your treating doctors.
When your injuries are classified as stable and stationary, WorkCover may arrange for you to be assessed to determine your degree of permanent impairment and following that assessment, issue you with a Notice of Assessment.
Once received, the Notice of Assessment may include an offer of lump sum compensation.
In order to bring a successful common law claim, you must prove that your injury was caused by your employers’ negligence. In other words, you must prove that your employer failed to ensure you were safe at work and failed to take proper care to prevent you from suffering injury. This concept is known as negligence.
(a) When can I commence a WorkCover Common Law claim?
(b) How to commence a WorkCover Common Law claim
A WorkCover statutory claim is a ‘no fault’ claim, that is you do not need to prove negligence (fault) against your employer to be eligible for benefits. A common Law claim is a claim in negligence where, to be successful, you must first prove that your employer’s negligence caused your injury.
If your WorkCover statutory claim is accepted you may be entitled to lost wages, medical treatment costs (e.g. doctor consultations, medication, x-rays), hospital costs, rehabilitation costs (e.g. physiotherapy, return to work programs), travelling expenses, lump sum payment for permanent impairment, death benefits and funeral expenses.
You must lodge a WorkCover statutory claim within six (6) months from the date of the work injury, or within six (6) months from the date you were first diagnosed with a work injury.
You (the injured worker), your treating doctor (e.g. GP) or your employer can lodge your WorkCover statutory claim.
The scheme requires employers to hold insurance within 5 days of employing you, or WorkCover Queensland may impose a penalty of $33,522.50. If you are injured at work and your employer does not have insurance, you have the right to contact WorkCover and they will manage the process.
You must make a choice between accepting any lump sum offer from WorkCover, or pursuing a Common Law claim for damages. This is referred to as an ‘irrevocable election’ meaning the choice you make cannot be changed. You should not respond to any offer without first seeking legal advice.
You should seek legal advice immediately if your WorkCover statutory claim is not accepted as there are strict time limits that apply and steps that must be taken to protect your interests and to give you the best chance of your claim being accepted.
Evolve Legal assists individuals with tailored legal advice to fit their individual needs. Call Evolve Legal today on 1300 025 101.