Can I Dispute My WorkCover Weekly Payments Decision in Western Australia?

TGB’s Tim White writes about disputes relating to workers compensation weekly payments in Western Australia.

Injured workers in Western Australia are covered by the Workers Compensation and Injury Management Act 1981.

Briefly, an injured worker has a number of entitlements under this Act, including:

1. Reasonable medical treatment;
2. Weekly payments whilst incapacitated for work;
3. Rehabilitation assistance;
4. Lump sum payment for permanent injury;
5. Reasonable travel costs.

There are common areas of dispute between employees and employers in regards to a person’s entitlements under this legislation. If you are an injured worker and disagree with a decision, in the majority of circumstances you are entitled to lodge a dispute.

Weekly Payments

 An injured worker is effectively entitled to the average of their weekly wage while they’re unable to work or while their ability to work is restricted.  So if you are absent from work due to a work injury, your weekly payments should be similar to what you were earning at the time of the injury.  If you believe that your weekly payments are less than what you are entitled to, you can dispute the decision. It is important that such disputes are filed in a timely manner as there are set time limits that apply.

There are numerous disputes that can occur in relation to weekly payments, including:

1. Your payments being suspended due to you failing to attend an arranged medical appointment;
2. Your payments being suspended due to a failure to engage a rehabilitation or return to work plan;
3. Your payments being ceased or reduced as a result of medical evidence indicating your work injury no longer causes you restrictions.

This is just an example of a few of the areas in which disputes frequently arise in regards to weekly payments.

With any dispute, whether it relates to weekly payments, medical expenses or otherwise it must initially be heard by a conciliation officer. A conciliation officer will list a dispute for a meeting and may require the injured worker and/or employer to attend. You are entitled to legal representation at a Conciliation Conference.

If the matter cannot be resolved at conciliation it can be referred for arbitration.  Arbitration is a more formal process than conciliation and usually the parties are legally represented.

On occasions when a dispute relates to a medical issue, the arbitrator may refer the question in dispute to a Medical Assessment Panel.  An injured worker is then required to attend the Medical Panel for assessment and a written opinion is then provided by the Medical Panel. There are various medical questions that could be considered such as:

1. The level of permanent impairment injury;
2. The reasonableness of a particular medical treatment;
3. The ongoing need for a particular type of treatment and/or medication.

Under the legislation a worker is entitled to, in certain circumstances, recover the legal costs involved in the costs of a dispute proceeding.  The legal costs that are recoverable vary in each case, however, in a large proportion of cases a significant amount of actual legal costs incurred by an injured worker can be recovered.

Workers compensation disputes are complex, and strict time limits apply for injured workers who want to challenge a decision. It is highly recommended to seek legal advice from an experienced workers compensation lawyer.