Injury
Personal injury arising out of or in the course of employment

Physical / psychological injury

Aggravation / deterioration of underlying disease

  

Compensation

Not payable UNLESS employment concerned was a
Substantial contributing factor to the injury

 

 

Essentials

Note all injuries in accident book within 6 months, keep copies of any claim forms lodged, certificates, /x-ray reports etc.

All injuries must be reported within 3 years and before termination / resignation.

  

Journey Claims

Coverage for daily journey to and from work / Tafe etc.

ONLY  outside of your home boundary

  

Psych Claim

Employment must be a substantial contributing factor

No compensation payable if injury from reasonable actions of employer. Need 15% WPI to claim lump sum.

Certificate - medical diagnosis, not just “stress”

  

Death Claim

Results from work injury-lump sum payable to dependants

Weekly compensation to children; funeral expenses.

 

Benefits

a)         Weekly Compensation

Total-base Award rate – first 26 weeks

Partial- Makeup pay if ongoing loss

No job – 80% rate -1 year

Obligation to look for work and notify

Insurer of all work applications / work done

Then statutory rate for all further periods of incapacity.

 

b)         Treatment

Hospital / medical/Physio/Chiro/chemist

Travel expenses - $0.55c per km

Domestic assistance if severe injury

 

 

c)               Permanent Disability / Impairment

Condition must be stabilised – not settlement

 

1)         Injuries before 1.1.2002

a)        Table of disabilities

b)        Disability worth $10,000.00 then also pain & suffering bonus payment.

 

2)         Injuries after 1.1.2002

a)      New impairment guidelines –whole of person impairment

b)      10% whole of body impairment ($12,500.00) to qualify for pain & suffering bonus payment

c)      Amount of compensation increased by 5% for injuries to back after 1.1.2006 and all injuries after 1.1.2007

Industrial Deafness

 

-             Claims against last noisy employer

-             Referral from GP to ENT Specialist Audiogram

-             No claim below 6% binaural (WPI-3%)

-             Claim before turn 50 and / or termination

 

New procedures apply to assessment of whole person impairment by Approved Medical Specialists. WorkCover has directed insurers not to negotiate WPI (Whole Person Impairment) assessments –accept Insurer offer or proceed to AMS (Approved Medical Specialists.) which are binding on all parties with only limited rights of appeal.

 

 

Common Law

     Must prove negligence or fault – contributory negligence applies

        Severe injury – 15% whole person impairment assessed / paid

        first to be able to proceed

        Three year time limit to commence Court action

        Wage loss only recoverable if successful

        No continuing medical or income support

 

Motor Accidents

Fault of another driver

6 months to lodge a claim form

Three year time limit to go to Court if liability in dispute or to lodge CARS Application

More than 10% whole person impairment or no damages for injury /disability/pain.

Wage loss / treatment claim as lump sum

No further claim or workers Compensation for that injury.

 

Commutation

Limited power to obtain lump sum settlement of all future rights

from Insurer – must have 15% WPI and other requirements

 

Dispute Resolution

Employer sends claim / certificate to Insurer within 7 days

Insurer must start payments 7 days later

Interim payments unless reasonable excuse

 

 

New Dispute procedures

No access to Compensation Court

 

Teleconference – 35 days, arbitration – 21days

 

 

Contact AMIEU Newcastle & Northern Branch Office 1800 095 400 for specialist advice and assistance in the event of any injury and dispute.

 

 

Severe penalties apply for false claims

 

Claims determined by Arbitration with no automatic right of hearing

 

All documents to be lodged with Application – can cause delay