Workers Compensation Claims
If you have been injured at work you may have an entitlement to compensation. However, accessing this compensation is not always straight forward.
In order to claim workers compensation, your injury must arise out of or in the course of employment, and your employment must be a significant contributing cause of the injury.
In addition, if you have a psychological injury, your employment must be the significant contributing cause, and the cause of your injury must not have arisen out of reasonable administrative actions implemented in a reasonable manner. For example, depression arising out of a decision not to award a promotion will not normally be compensable.
- Income maintenance payments;
- Reasonable medical expenses;
- Lump sum payment for disability; and
- Lump sum payment for economic loss.
Seriously Injured Workers
The RTW Act creates a new category of worker known as a ‘seriously injured worker’, who has different rights and entitlements under the Act. In order to be assessed as a seriously injured worker, your ‘whole person impairment’ must be assessed by an accredited doctor as being over 30%. If you are classified as a ‘seriously injured worker’ you will likely receive income maintenance until retirement age, and medical expenses for life.
If you are not classified as a seriously injured worker your entitlements are far more limited. As the change in the name implies, the focus of the legislation has turned to returning workers to the workforce. As a result, income maintenance has been capped at two years, and medical expenses for a further 12 months following your payments stopping.
As a result of these changes, it is easy for a worker to be overwhelmed with the ‘push’ to return to work. Difficulties can arise with Return to Work Plans, Case Managers, or even Employers. A worker has the right to contest many decisions made with respect to their case at the South Australian Employment Tribunal, however, the biggest misconception most workers are placed under is that they ‘don’t need a lawyer’.
The new legislation has also placed further obligations on the employer to provide suitable duties, taking into account your restrictions. If such duties are not forthcoming, the worker can apply to the Tribunal for an order that the employer provides suitable duties.
If you do need to contest a decision at the Tribunal, it is recommended that you instruct a solicitor experienced in the jurisdiction. The compensating authority (Gallagher Bassett, Employers Mutual or the Self-Insured Employer) will always instruct lawyers to appear on their behalf.
Under the legislation, should your matter proceed to the Tribunal the compensating authority is required to pay a portion of your legal costs unless the matter is found to be frivolous, vexatious, or misconceived. An experienced lawyer can, therefore, maximise the costs claimable from the other side, and minimise your out of pocket expenses.
Lump Sum Entitlements
Even if you do not need to contest a matter at the Tribunal, legal representation is recommended. For example, most workers are informed by their case manager that they can assist them to obtain their lump sum entitlement for a disability under section 58, without a lawyer’s involvement.
Under the changes in legislation, you are only able to have one lump sum payment for disability. As a result, it is crucial that all of your injuries have been identified, claimed and assessed. In addition, there are complicated rules regarding what injuries can and cannot be combined, which will affect the amount of your lump sum payment.
Solicitors are also familiar with the doctors who are accredited to assess workers under the scheme and so can assist you in selecting the most appropriate doctor for your case.
Finally, the amount of your ‘whole person impairment’ will affect how much you receive for your economic loss lump sum. It is, therefore, crucial to get this assessment right.
Georgiadis Lawyers offers a free first interview, so if you have a potential workers compensation claim contact us to arrange an appointment to discuss the same. Workers compensation – We get it done!