An employer in Queensland is legally obliged to maintain accident insurance to cover the unfortunate event that one of its employees is injured or experiences illness as a result of their work.
In Queensland this insurance policy is generally taken through WorkCover Queensland, who deal with no-fault statutory claims for workers’ compensation when an employee is injured or falls ill at work. For an injured worker, claims under the statutory scheme can pay weekly payments as income replacement, lump sums to compensate for permanent impairment, and hospital and medical expenses as compensation.
Some employers can also be licensed for ‘self-insurance’, meaning they independently manage the costs and risks of any workers’ compensation claims arising from injuries to their employees. There are a number of requirements an organisation needs to meet in order to be eligible for a self-insurance scheme, including employing more than 2,000 full-time workers (within Queensland), demonstrating a satisfactory occupational health and safety (OHS) performance, re-insurance cover, financial capability and a workplace rehabilitation policy and procedure, among others.
What claims can an injured employee make?
If you’re an employee covered by a workers’ compensation scheme and you’re injured at work, or your role at work caused you illness, you may be able to make both a statutory (no-fault) claim with WorkCover Queensland (or a self-insurer) and a common law claim against your employer.
Compensation claims in Queensland must start with a statutory (no-fault) claim, before you can make a common law claim, which needs to demonstrate that negligence on behalf of your employer caused your injury.
If you have an accident at work or believe you have an illness caused by work, there are a number of steps an employee needs to take:
- Visit a doctor or go to the hospital to have your injury assessed and receive initial treatment as soon as you can after the incident.
- Obtain a work capacity certificate from the doctor you see, which will detail your work related injuries, whether or not you can continue to perform work duties and the treatment that you need.
- Inform your employer about the incident as soon as possible and provide them with your work capacity certificate. Many workplaces will, of course, have an incident reporting process prior to this step, and possibly on-site medical assessment.
- Lodge your claim with WorkCover Queensland, along with a copy of the work capacity certificate. If your employer is self-insured, it will likely have its own process for lodging a claim.
- Begin rehabilitation as soon as possible. Employers are obligated to help with an employee’s rehabilitation and – with a work capacity certificate – assistance can be accessed for general practitioner appointments, counselling or psychology sessions, psychiatry appointments and some hospital costs before your claim is decided to help with this process.Expert legal advice can prove invaluable at this time.
You should also keep all records relating to your injury, including receipts for medical treatment, travels costs to and from, and any other expenses incurred as a result of the accident as you may be able to seek reimbursement from the insurer.
What do employers need to do at this stage?
For an employer there are also steps to take when an employee is injured at work. Employers should first ensure that any accident reporting procedures are accurately and diligently followed, and make contact with the employee to check on their welfare.
An employer is obliged to inform WorkCover Queensland about any workplace incident, whether or not the worker subsequently makes a workers’ compensation claim. For self-insured organisations, they need to inform their relevant insurer about the incident.
As mentioned, employers also need to engage with the injured employee in regard to rehabilitation and whether they are able to resume their usual duties, or modified or lighter duties, at a time to be determined.
Some workplace incidents also require notification to Workplace Health and Safety Queensland.
What happens once a workers’ compensation claim is made?
WorkCover Queensland or the insurer providing coverage for a self-insuring employer undertake their own investigation of any claim for workers’ compensation before either accepting or rejecting the application. This may include a further expert medical assessment of your injury or illness.
Some of the factors that WorkCover Queensland or the self-insured employer takes into account in conducting this process includes asking:
- whether the claim is made within the right timeframe;
- whether the claimant is actually a worker in Queensland;
- whether the claimant’s injury is work-related, how long they are unable to work, and what treatment is required for the injury.
If your claim is rejected or you’re otherwise unhappy about how your claim was handled, it’s possible to ask for the decision to be reviewed by the Workers Compensation Regulator. Speaking with a legal representative with expertise in compensation matters, such as our team at Bourke Love, is highly advised as we can help you make the best argument for why your claim should be accepted.
Common law claims
Once your statutory claim is resolved either way with WorkCover Queensland or a self-insurer through the issuing of a Notice of Assessment, you may be able to make a common law claim if you believe your injury was caused by the negligence of your employer.In simple terms, a common law claim requires that you show your employer owed you a duty of care, that it breached this duty, and that its breach caused the injury for which you’re claiming compensation. This claim can potentially see an injured person awarded a larger sum than is obtainable under the statutory scheme.
A successful claim may see damages awarded for economic loss (lost wages, for e.g.), pain and suffering, legal costs, medical and hospital costs.
It is imperative that you seek legal advice prior to responding to the Notice of Assessment statutory offer as you will not be able to proceed to the Common Law stage if you accept the offer unless your injury has been assessed as being more than 20% permanent impairment.
Important Time Limits
A claim for common law damages arising from a personal injury must be commenced within 3 years of the cause of action. If you do not comply with this time limit, any claim you have may be extinguished and you may be precluded from commencing an action for damages.
The importance of good advice
At Bourke Love Lawyers, we’re specialists in workers’ compensation claims with years of experience advising injured workers as well as employers about their rights and obligations.
In our area of practice in northern NSW and south-east Queensland, in particular, we provide expert advice and guidance about work-related injury or illness, whether you’re making a statutory workers’ compensation claim or a common law claim for negligence.
Pursuing compensation for work injury can be a stressful process. From medical assessments to lost income, dealing with insurance companies and meeting deadlines for filing claims, it can all seem too much. At Bourke Love, we remove the difficulty involved by doing the time-consuming, detailed work for you. Our friendly team will take you through the process step-by-step in order to give your claim the best chance of success.