Workers Compensation Survival Kit – Part 1

In Part 1 of the Workers Compensation Survival Kit, Adelaide injury lawyer Mal Byrne writes about commencing a workers compensation claim.

Suffering a work injury and being ‘on Workcover’ is no bed of roses. It doesn’t help that the level of mythology surrounding Return to Work SA (formerly Workcover) compares favourably with that of Ancient Greece.  It doesn’t help that the community is full of well meaning ‘bush lawyers’ prepared to offer their twenty cents worth of advice to injured workers on the subject.  So, if you or your loved one are an injured worker, this is Part 1 of a series of blogs to navigate you through the maize of claims managers, doctors, physiotherapists, rehabilitation providers,  Tribunals, and god help you, LAWYERS!, that you may confront.

COMMENCING A CLAIM

If you suffer a work injury and want to claim workers compensation, you need two completed forms, one from yourself and one from your doctor.  You must complete a Claim Form.  Your employer should have hard copies of the form.  The form can also be downloaded from the Return to Work SA website.  The legislation also requires injured workers to report workplace injuries to their employer within 24 hours of the event and if that’s not possible, as soon as is reasonably practicable. Regardless of the legislation, you should always report any work injury to your supervisor or the designated person at work even if you are able to keep working and do not plan to claim Workers Compensation.  If a record of the injury is on file and you suffer a deterioration or recurrence at a later date and have to stop work and claim workers compensation, the earlier record of the symptoms will lend support to your claim especially if the injury is a repetitive use injury where the symptoms commence and then gradually worsen over time.

If you have already submitted a claim for Workers Compensation and are receiving WorkCover payments, you should still submit a Claim Form on each occasion that you experience an exacerbation or deterioration of your condition at work.  For example, if you have returned to work on light duties and/or reduced hours and aggravate your existing injury doing those duties, you should submit a new Claim Form.  There are benefits in doing so, particularly in relation to weekly earnings calculations.

In addition to completing the Worker Report Form, you must submit a Work Capacity Certificate on the applicable Workers Compensation stationary setting out the nature of the injury, the date of injury, confirming that the injury is work related and whether you are fit to return to work, and when he or she will be seeing you again to review your progress.  The certificate is a medical certificate and can only be provided by a doctor. Please note that ordinary sickness certificates or Centrelink sickness certificates will not suffice.

Once you have your completed the Claim Form and obtained the Work Capacity Certificate from your doctor, you should submit both documents to your employer.  The employer should promptly send the claim to Employers Mutual Limited (EML) or Gallagher Bassett Services Workers Compensation SA, the insurance companies or claims agents as they are called who manage all workcover claims on behalf of Return to Work SA.  The only exception is where your employer is an exempt employer.  An exempt employer is a large employer permitted by Return to Work SA to manage their own claims.  Examples of exempt employers include Holdens Ltd, the State of South Australia and Clipsal.  If you are employed by an exempt employer, that employer will manage your workers compensation claim.

You should keep copies of both the Claim Form and Work Capacity Certificate.  If the employer refuses to submit the docume

Part 2 of the Workers Compensation Survival Kit will cover the investigation and determination of claims.

For a free initial interview about your workers compensation claim, contact us. TGB is South Australia’s largest injury law firm and is also now open in Western Australia and Northern Territory.