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Workers Compensation Claims – General Q&A

Workers compensation is awarded to people suffering from work-related injuries. NSW employers are bound to take out workers compensation insurance to cover physical damage, psychological suffering and any disease contracted during employment. Compensation payments also cover aggravation of an existing ailment and in very limited circumstances injuries sustained travelling to and from work. NSW compensation law covers all workers; full time, part-time, casual and commission, while subcontractors may also be deemed ‘workers’ depending on reciprocal arrangements.

What is required to lodge a claim?

To lodge a workers compensation claim a worker must have sustained an injury during employment. Medical evidence establishing the severity of the injury or ailment is required, along with proof the incident occurred as a result of employment. Information should be submitted to the employer as soon as the worker is aware of the injury, with the information then forwarded to the insurer for determination of liability.

What must my employer do if I am injured at work?

If you are injured at work and notify your employer, their first responsibility is to arrange appropriate medical treatment. Employers are advised to complete an incident report for the perusal of their workers compensation insurer. Employer support is also required when it’s time for injured employees to return to work, including the provision of suitable duties wherever possible.

What happens if the employer is uninsured?

In NSW it is compulsory for all employers to hold a valid workers compensation policy. However, not all employers adhere to this legislation and there are occasions where injured workers are not supported by a valid workers compensation policy. Fortunately, the ‘uninsured liability scheme’ managed by Icare provides an avenue for workers to make a compensation claim. Injured workers using the uninsured liability scheme are treated the same as all other injured workers, with the same entitlements.

How long do I have to make a workers compensation claim?

Workers compensation claims should generally be made within a period of six months from the date of injury, although some injuries and ailments affect physical or mental capabilities over time. There is a degree of flexibility in compensation claims if medical or other evidence is provided to support your position. Whenever possible however, the injury should be reported immediately.

Do I need to prove my employer was negligent to make a workers compensation claim?

No. Workers compensation is a “no fault system” and negligence does not need to be proven to make a claim.

What type of injuries are covered by workers compensation?

Workers can make a claim for any physical or psychological injury that has been sustained during employment or while engaged in work related activities. This includes the gradual onset or diseases which are aggravated, accelerated, exacerbated or deteriorated due to employment, provided employment is the main contributing factor.

What are the types of workers compensation benefits?

Injured workers may be entitled to the following benefits depending on the nature and severity of their injury:

  • Weekly compensation
  • Medical, travel and rehabilitation expenses
  • Lump sum compensation for permanent impairment
  • Domestic Assistance
  • Death benefits including funeral expenses
  • Property damage expenses

Compensation payments generally fall into two categories:

  • Weekly payments to compensate for lost income resulting from injury
  • Medical expenses or ongoing costs directly attributed to the injury

Are other work-related activities also considered ‘employment’?

The term ‘in the course of employment’ refers to regular work duties and other activities organised by the employer. These can include lunch time leisure pursuits with colleagues, special work occasions, and in very limited circumstances travel to and from the place of employment. Generally there is ‘no fault’ attributed to the claimant, although in cases of serious workplace misconduct further investigation of the claim will be required.

How is suitability to return to work assessed?

Employers have an obligation to provide a safe and healthy workplace. A return to work can be achieved by providing restricted work duties to facilitate ongoing recovery or as an adjustment for the worker’s partial disability. There are several considerations to examine prior to returning to work.

  • The nature of the injury or illness
  • Expected recovery timeframe
  • The impact of injury on an employees ability to perform regular work duties
  • Measures required to assist the employee perform pre-injury position duties
  • Legislative measures that require satisfying prior to a return to work

Workers compensation is an important finance and health safety net, ensuring NSW workers are provided with a safe working environment along with financial and medical assistance for times when inevitable accidents and incidents occur. Taylor & Scott workers compensation lawyers are renowned for achieving desirable client outcomes in Sydney and regional NSW for workers from all walks of life.