Injured Workers

Questions and Answers What should an injured worker discuss with their nominated treating doctor during the initial consultation? It is important that injured workers communicate with the nominated treating doctor exactly how the injury occurred. All injuries sustained in the accident should be recorded even if they appear to be minor at the time as…

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Suspension & Work Capacity

Weekly Compensation Can the insurer suspend or reduce payments of weekly compensation? The insurer may suspend or reduce payments of weekly compensation if the worker fails to: provide a current certificate of capacity provide relevant documentation such as wage records, medical reports or statutory declarations that have been requested by the insurer attend medical appointments…

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Medical Expenses & Treatment

Questions and Answers How long does the insurer have to make a decision on medical treatment? The insurer has 21 days to determine a claim for medical expenses. Can I claim for domestic assistance? In order to claim for domestic assistance an injured worker must: Be certified by a medical practitioner that domestic assistance is…

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Provisional Liability

Questions and Answers What is provisional liability? Provisional liability is an interim decision on liability. It allows for financial assistance to be provided whilst the claim is investigated and a decision on actual liability is made. How long is provisional liability? Provisional liability is for a period of 12 weeks or up to $7,500 in…

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Property Damage

Questions and Answers How long does the insurer have to determine a claim for property damage? The insurer has 28 days to determine a claim for property damage.

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Weekly Compensation – With Capacity to Work

What are my entitlements to weekly compensation during the first entitlement period if I have capacity to work? The first entitlement period is the first 13 weeks of weekly compensation. During the first 13 weeks of weekly compensation where a worker has capacity to work, payments will be calculated at 95% of the workers pre…

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High Needs Workers

Questions and Answers What is a worker with high needs? A worker with high needs is a worker who has 21% whole person impairment or more, including workers who have not yet been assessed but the insurer is satisfied that the level of impairment is likely to be 21% or more. It also includes workers…

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Factual investigators

Questions and Answers Can the insurer arrange a factual investigator? The insurer can arrange a factual investigator to interview injured workers and other witnesses to obtain a statement to assist with the determination of liability. Insurers can also use factual investigators to conduct surveillance and obtain footage of injured workers after their injury as a…

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Insurer Deny Responsibility

Questions and Answers Why might the insurer deny liability? There are a number of reasons why the insurer may deny liability for injury, weekly compensation, medical treatment or lump sum compensation. These reasons can include: Injury was not sustained at work The injured person is not a worker for the purposes of workers compensation Employment…

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Workers Compensation – Heart Attacks & Strokes

Questions and Answers When can the insurer arrange an Independent Medical Examiner? The insurer can arrange an independent medical examination if information from the treating doctors is inadequate, unavailable or inconsistent or the insurer cannot resolve issues directly with the injured worker’s treating doctors. How much notice do the insurers have to provide workers before…

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