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Workers’ Compensation Claims

Have you been
injured at work?

Here you’ll find the information you need to know to make a claim.

Have you been injured at work and the insurance company is refusing to help? It’s often the case that insurers decline to pay for things like medical expenses and even weekly wages, leaving the injured person with little or no help. We’re here to force the insurers to do what they should have done from the start – to pay you the things you’re entitled to! We hope you find the information below useful but please ensure you obtain legal advice in relation to your claim.

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Jimmy Dufour explains Workers’ Compensation claims

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What are the different kinds of Workers’ Compensation cases?

There are a number of different kinds of Workers’ Compensation cases so it’s important your lawyer has had experience with the various cases. It’s often the case that different cases require different kinds of investigations. Your case may fall into one or more of the categories listed below and if so, please click on the category to find out more.

Building site / construction cases

Building site / construction cases

Injuries on building sites often require extensive legal analysis to determine the particular actions that an injured worker may have.

Often it can be the case that a worker employed by a particular entity is injured as a result of another party’s negligence. For instance, a carpenter could be working on a building site which also has other trades and/or a head builder working on it. That carpenter may sustain injury as a result of a hazard left by an electrician who is not employed by the same company. Not only will the injured worker have a claim against their employer but they will also have a significant negligence claim against the party at fault. On building sites, the party at fault could also include a site manager, an owner, a head builder or other contractors.

It is imperative that anyone injured in this scenario – or on a building site generally – contact us to look into all actions available. Without proper due diligence, there may be significant compensation at risk.

Contractors and Sub-contractors may also be self-employed or employed with a company. If injured during the course of their employment then they may have a claim for Worker’s Compensation – even if they are self-employed and at fault.

If a self-employed worker has no insurance, they may be able to claim Worker’s Compensation against a head contractor. Further, if you are a worker and your are injured working for someone without workers compensation insurance, you can still likely claim Workers Compensation.

Injuries on building sites can be complex Workers Compensation claims and can also give rise to additional claims against third parties. You should give us a call to discuss your claim – even if it’s for a second opinion.

Claims for Psychological Injury

Claims for Psychological Injury

In a claim for psychological injury, an injured worker needs to establish the following:

i) Work was the main contributing factor to the injury.

To establish this, an injured worker must show that the actions of the employer, the company, or the demands of the job itself, led to your injury or incapacity to work.

It may be that other factors were involved – such as unrelated traumas or personal issues – but as long as work is the main factor, then the claim can succeed.

Please note that an aggravation or exacerbation of an old or previous psychological injury is okay as long as the aggravation or exacerbation was caused by work. For instance, a person with pre-existing depression that is triggered by poor management would still have a claim

ii) The injury needs to be a recognisable psychiatric condition as opposed to ‘stress’

This obstacle is put in place to stop people making a claim for worker’s comp when they are ‘stressed’ given stress is not defined as a  psychological injury for the purposes of the Workers Compensation legislation. However many people suffering from stress may also have a psychological injury. Examples of psychological injury include:

  • Depression
  • Anxiety Disorder
  • Post-traumatic Stress Disorder or PTSD
  • Adjustment Disorder

It is important to have your condition diagnosed by a Doctor. The Doctor may then determine the type and cause of any psychological injury and any further treatment – such as counselling, psychiatric treatment or medication. Please note that any treatment will likely be covered by Worker’s Compensation or Medicare.

iii) The Injury cannot be caused by the reasonable actions of employer

If the injury is caused by the reasonable actions of the employer in relation to, for instance, promotion, demotion and/or performance appraisal – then this may be a defense against a Claim. However an employer still has a duty to act reasonably in these circumstances. We have won many cases arising from unreasonable actions of employers, even during warnings or other performance appraisal, or when other factors have contributed to the injury.

Cases where people are employed through an employment agency

Cases where people are employed through an employment agency

This type of claim typically involves an employee of an employment agency or labour hire company being sent to work for another company or other third party. This is becoming increasingly common in the modern workplace.

A common example would be for an employee to do their induction and be paid wages by an agency, but do their daily work at a Factory – sometimes of varying location.

Sometimes employees are not even aware they are hired by a third party, and thus an employee should always check who is paying their wages.

Other than potential compensation entitlements, those employed through Labour hire or employment agencies may have an alternative claim or an additional party to sue. That is, they may also have a claim in Negligence against the party who has the contract with the agency. Such a claim against  often provides options for a greater amount of compensation than Workers Compensation and can include money for Pain and Suffering and other Future Losses, including Economic Loss.

It is important for a lawyer to look into this type of claim for you, as it may mean you have significant entitlements beyond your weekly payment and medical treatment covered by Worker’s Compensation. It also allows the injured party to continue to receive these Workers Compensation benefits whilst we can explore other claims and entitlements on your behalf.

Cleaners

Cleaners

Cleaners can often suffer injuries in the workplace due to the physical demands of the job and the environments in which they may work. Such injuries his may often include back, shoulder and neck injuries as well as repetitive strain injuries such as Carpel Tunnel Syndrome.

Cleaners are a group of workers that may have entitlements to Worker’s Compensation against their direct employer, as well as a Public Liability claim against the owner/occupier of the place being cleaned, or any third party directing them in their duties.

By way of example, if an employed cleaner was cleaning a home and fell on some kind of trip hazard, suffering injury – not only would the cleaner be likely to have a Workers’ Comp Claim, but they may also be able to sue the home owner (who would likely have a public liability insurer) for in negligence.

Worker’s Compensation benefits would allow the injured cleaner to receive weekly payments for between 2.5 and 5 years depending on the level of impairment, and any reasonable medical treatment during that time. There may also be a moderate entitlement to lump sum compensation.

The home owner will usually have public liability insurance, and often the insurer will therefore pay any monies under the claim. Such rights can be explored as well as any workers compensation rights. These claims can be far bigger and if negligence is proved then can result in a tax free lump sum payment for pain and suffering and all future losses, including economic loss.

It may be this is the only claim available to some cleaners that are working independently and without any Worker’s Compensation insurance.

Office Workers

Office Workers

Office Workers are not immune from Workplace Injuries. There is a strong prevalence of back and neck problems which can be caused by constant use of computers and/or lifting.

There has also been a significant number of Psychological Injury Claims with many of these arising from common office situations. These can be caused by the high stress nature of the work involved, overwork, bad management or bullying, harassment and victimisation.

An example of this would be a secretary or accountant being bullied and harassed by her manager. This may include unfair punishments, overwork and unrealistic expectations or even sexual harassment. The worker may need psychological treatment and time off from work, both of which should be covered by Worker’s Compensation. If the impairment resulting from the injury is high enough (15% Whole Person Impairment), then the worker may even be eligible to sue their employer in Negligence in a Work Injury Damages claim (see below).

Nurses and Care Workers

Nurses and Care Workers

Nurse and Care Workers, including both disability and aged care workers can often suffer injury in the course of their employment. Their work requires significant lifting, bending and twisting, moving and care of a variety of patients. This work can easily lead to injury.

An example of this would be a nurse or an aged care working moving a patient from a wheel chair into a shower and suffering a neck, back or shoulder injury in the process.

Such cases usually lead to Compensation for medical expenses and time off for rest and rehabilitation or until more suitable work can be found. There may also be right to Work Injury Damages (Negligence Claim) if the injuries are significant.

There may also be assaults or abuse from patients which should not happen. It is imperative for all care workers to be afforded the best protection from their employer, adequate training and a safe system of work.

Lastly, often it is the case that nurses or aged care workers are employed through employment agencies. In such a scenario they may have an additional cause of action. See our information on ‘Cases where people are employed through an employment agency’ above.

Tradespersons

Tradespersons

Builders, Carpenters, Plumbers, Electricians and other trade persons will often suffer injuries in the workplace due to the nature of their work. Building sites are dangerous places and often have a number of different parties and companies working together under different direction. This can lead to complexities in ascertaining the party at fault.

Many accidents can be serious and can lead to significant injuries or death. Examples include electrocution, machinery accidents, forklift incidents or slip and falls. It is important to get the legal advice in relation to these claims.

There may be a number of different claims available to you. A Worker’s Compensation Claim can be made against the employer. Sometimes the worker may be self-employed but a claim can still be made against the company and its insurer.

If the accident was the fault of a third party or company, such as a different tradesperson on a building site, then there may be other claims available including Negligence and Civil Liabilities actions.

Warehouse Workers

Warehouse Workers

Factory workers, like all employees, have right under the Worker’s Compensation Act. If they are injured in the course of their employment they will have rights medical treatment, lump sums and weekly payments whilst they are unfit to return to work.

Emergency Service Workers

Emergency Service Workers

Police, Fire and Ambulance Officers are subject to extremely difficult and stressful situations. As a result, there are often physical and psychological injuries that may arise.

An example of this is an Ambulance Officer that has witnessed a number of traumatic road accidents. After many years the trauma builds up and the Officer goes off work suffering Post Traumatic Stress Disorder. This is not uncommon for Emergency Service Workers. It can be very debilitating, effecting their ability to work and potentially making them totally unfit to return to such stressful work.

In this case, the Ambulance Officer would have a claim for psychological treatment, medication as well as weekly payments while they are off work. If their incapacity is significant, they may require re-training or redeployment. There may also be entitlements to negligence if the State did not adequately look after its workers.

Emergency Workers are essential to our society and should be afforded the best chance to do their jobs safely and without ongoing trauma. This may be one of the reasons that Fire fighters, Paramedics and Police Officers are not subject to the workers compensation changes made in July 2012. This means they are entitled to more generous benefits than those occupations subject to the July 2012 changes.

Entitlements to those workers not subject to the July 2012 changes generally include Weekly payments for loss of income (which is available until statutory retirement age); reasonable and causally related medical expenses for life; and potential Lump sum claims for permanent impairment which may include an additional payment for pain and suffering.

What Can You Claim?

If you have sustained an injury, you may be entitled to compensation for the following:

Weekly payments or Loss of income

When you are off work because of an injury, you are entitled to receive weekly payments of up to 95% of your pre-injury earnings. Under the new legislation that was implemented in 2012, an injured person can receive weekly entitlements for up to 2.5 years and for serious injuries, up to 5 years or until retirement age.

The amount and duration that one can receive weekly benefits for depends on a number of things including how serious your injury is, and whether you have any capacity to work.

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If you were injured before or after the introduction of the new Workers Compensation Legislation in June 2012, what you can receive will fall under the new system of benefits:

  • For the first 13 weeks after your injury you are entitled to 95% of pre-injury average weekly earnings (PIAWE)
  • After 13 weeks you are entitled to 80% of your PIAWE if you have no current work capacity, 80% of your PIAWE less your ‘ability to earn’ if you are able to work and not working, or up to 95% of your PIAWE less your current earning if you are working at least 15 hours per week.
  • After 2.5 years you are able to receive 80% of your PIAWE if you have no current work capacity and this is likely to continue indefinitely, OR continue up to 95% of your PIAWE less your current earnings if you are working at least 15 hours per week and this is likely to continue indefinitely.
  • After 2.5 years, if you are certified to do some work however have not returned to employment, it is likely the insurer will try to cut you off all weekly entitlements.
  • To receive weekly benefits beyond 5 years, you must be classified as a “seriously injured worker”.

To find out if you are eligible for compensation, please contact us either by submitting an online enquiry via the form on this page or by calling us.

Medical treatment

After suffering an injury, the workers compensation insurer is responsible to pay for all of your reasonably necessary medical treatment. This includes radiological scans, GP and specialist appointments, physiotherapy, hydrotherapy, surgeries, and medications. You are also entitled to claim the cost of your travelling expenses in attending medical and rehabilitative treatment.

So that you are not out of pocket and paying for treatment yourself, the new laws require you to have all medical treatment requests sent to the insurer before undertaking it.

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In general, the new benefits scheme requires approval from the insurer before you organise any reasonably necessary medical and treatment related services. It is important to note that it is the responsibility of your medical or treatment provider to seek the insurer’s approval before starting your treatment.

If the workers compensation insurer declines to pay for something that your treaters have requested, you should contact our team immediately so we can advise you on all of your options on how we can force the insure to pay, and more importantly, so we can help you to obtain the treatment you need.

Lump sum compensation for permanent impairment

As a result of your injury at work you may be left with permanent disabilities and not able to do the things you used to do. Should you be left with ongoing impairment, we are able to investigate the possibility of making a claim for lump sum compensation, and in some limited circumstances, also for pain and suffering.

If you have lasting effects from your injury, we are able to have your condition assessed for lump sum compensation. This generally happens once your condition has stabilised and treatment options have been exhausted.

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It is important to note that any settlement of lump sum compensation does not finalise your other entitlements, and you will still be able to claim ongoing weekly payments and medical expenses.

The advantage of obtaining lump sum compensation (if available) is that this brings rise to an acknowledgment by the insurer that you have suffered a permanent injury which may assist in protecting your future rights.

Frequently Asked Questions

Who can make a Claim?

Who can make a Claim?

If you’re an employee and you are injured at work, it is likely you have a Workers Compensation claim.

Due to the way in which ‘Worker’ is defined in the Workers Compensation legislation, it may be the case that you have a claim even if you are a Contractor. Further, you are covered if your ‘injury’ was:

  1. Due to the nature and conditions of your employment; or
  2. If your injury is a ‘disease’.
  3. An aggravation, acceleration, exacerbation or deterioration of an existing injury
  4. A psychological injury including those that have arisen as a result of bullying, harassment or general mistreatment

How can I make a Negligence Claim against my Employer?

How can I make a Negligence Claim against my Employer?

If you have suffered a serious injury at work you may be able to sue your employer for negligence.

This is possible if you can establish that your injury was caused by your employer’s negligence. The question of Negligence is often not straightforward and a lawyer will be required to carefully determine whether there are arguments to suggest that your employer is negligent. Fortunately for injured workers, courts have determined that employers are held to a very high standard to safeguard workers from injuries.

In order to sue for damages, you must be assessed as having at least 15% whole person impairment and your claim must be issued in accordance with both strict time frames and procedures of the workers compensation legislation.

If successful, you will be entitled to receive damages for lost income (both past and future) in one lump sum.

What about my legal costs?

What about my legal costs?

Fortunately, as a result of some legislative changes, Schofield King Lawyers are now in a position where we can apply to have your workers compensation costs completely covered by the Workers Compensation Independent Review Office (WIRO). This means that we don’t need to charge you a cent.

For Negligence claims against your employer (Work Injury Damages Claims) we offer ‘No Win, No Fee’ and fixed fee costing arrangements. For more about our Cost promise, click here.

What Our Workers’
Compensation Clients Say

Don’t just take our word for it.
Trust the word of the many clients we’ve helped.

  • I was referred to Schofield King Lawyers, by another lawyer. He told me that they would be the best, that they would fight for me and would do everything possible to help me win. He didn't lie. Jimmy and the team worked with me to help me get the best outcome possible for my case. It was so good, even I, didn't anticipate it! Thank you to Jimmy and the whole team for your hard work and especially your patience with me when I was worried or stressing.

    Markou Workers’ Compensation Client
  • The care and advice I received was more than I ever expected and for which I’m greatly appreciative of. Thanks

    Guy Workers’ Compensation Client
  • Right from the first appointment I was treated kindly and with empathy. Everything was explained in detail and I was asked not to hesitate if I had any further questions. All my queries were responded to promptly. I highly recommend Schofield King Lawyers.

    Andrea Workers’ Compensation Client
  • Again , just wanted to thank Jimmy and his staff at the Narellan office, my case was tended to professionally and with empathy and understanding,  kindness and all done in a timely manner. I would recommend you guys in a heartbeat, cheers.

    Corey Workers’ Compensation Client
  • I felt I was alone and doubtful however Jimmy from Schofield King Lawyers reinstated my faith of believing in myself. Thank you Jimmy for winning my case. It matters more than you know.

    Kavita Workers’ Compensation Client
  • Schofield King Lawyers were very diligent and understanding of my workplace bullying and harassment work injury damages matter after having gone through 3 different solicitors/legal firms in over 4 years. Without the immediate help, patience and support of Schofield King Lawyers’ Andrew McQuilkin, my family would have continued to suffer emotionally, psychologically and financially.  This has given me and my wife the peace of mind we have been seeking for so long to begin our healing process.

    Sonny Workers’ Compensation Client
  • After injuring my back at work and being continuously denied liability by my insurance. With special thanks to Jimmy, have been in to battle and won me the right to get me the treatment I needed.

    Brian Workers' Compensation Client
  • Schofield King Lawyers, were fantastic, kept us up to date all the time, were always there to answer any questions, they were very professional at all times. I would have no hesitation recommending Schofield King Lawyers.

    William Workers' Compensation Client

Jimmy Dufour – Director & Senior Lawyer at Schofield King

What Can I Expect From
Schofield King Lawyers?

  • 1 We’ll help check for eligibility

    If you believe you may be eligible to make a claim, or have an existing claim, please contact us as soon as you can so we can discuss your situation. Our lawyers can discuss your claim on a ‘no obligation’ basis.

  • 2 It won’t cost you a cent

    As a result of some legislative changes in 2012, you can now have your workers’ compensation costs completely covered by the Workers’ Compensation Independent Review Office (WIRO). As our Workers Compensation lawyers are WIRO approved, this means we don’t need to charge you anything. Funding grants are subject to approval.

  • 3 We’ll help you lodge your claim

    Our team of lawyers have extensive experience with the various workers compensation disputes. Upon lodging a Workers’ Compensation claim, the insurer will determine whether they believe they are liable for the claim.

  • 4 And asses the insurer’s position

    Let us do our best to make insurance pay.

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