How to challenge a rejected Workers’ Compensation Claim

Accidents at work can happen unexpectedly. If you’ve been injured at work, you may be entitled to Workers’ Compensation, covering medical expenses and potentially providing lump sum compensation. If your injury is severe and you are unable to work for a period of time, you may also qualify for financial support during your recovery. However, not all claims are accepted, and if yours is rejected – or if you’re not satisfied with how it’s been accepted – it’s important to know your options.

Steps to Take After a Workplace Injury

1. Report the incident immediately.

Even minor injuries should be reported promptly. Delays could result in a rejected claim. Prompt reporting helps establish a clear link between the injury and the workplace and ensures quicker medical attention, preventing complications and aiding recovery.  It also ensures evidence, such as CCTV footage, is preserved to assist with supporting your claim. Proper reporting can also help safeguard against potential employer disputes related to your injury.

2. Gather your own witness statements.

If anyone witnessed the accident, ask them for a brief statement. Lack of witnesses is a common reason for claim rejection. Also, gather any relevant evidence, such as meeting notes, emails, or text messages, that help confirm the incident occurred.

Once your report is filed, your employer or the compensating authority may request additional evidence, including medical records.

Common Reasons Workers’ Compensation Claims are rejected

1. The injury did not occur at work.
2. You had a pre-existing injury or condition.
3. You were under the influence of drugs or alcohol.
4. The injury happened outside of work hours.
5. The injury was deemed too minor to affect your job.

Common issues with claims that have been accepted

1. Incorrect Average Weekly Earnings (AWE) rate.
2. My claim is accepted for medical expenses only.
3. Weekly payments accepted for a closed period.
4. Not all of my injuries have been recognised in the determination.

Disputing a Determination

A rejected claim isn’t the end of the road. You have the right to challenge the Determination. Likewise, if your claim is accepted but you don’t agree on the terms, then you can still dispute it.

Either way, seeking legal advice is crucial. An experienced lawyer can review your case, identify missing information, and assist in filing an Application for Review.

In South Australia, you have one month to request a review with the South Australian Employment Tribunal. In some circumstances you may be able to request an extension of time, and a lawyer can help you with this process. Claims can be rejected simply due to errors or missing details/information. Legal support can improve your chances of success.

Need Legal Assistance?

If you’ve been injured at work or need help filing a claim, contact our experienced legal team for guidance. We’re here to help you navigate the Workers’ Compensation process and secure the compensation you deserve.

T: (08) 8205 1221

E: ctsoubarakis@tgb.com.au